Busse J C, de Velasco R E, Pellegrini E L
South Med J. 1991 Apr;84(4):502-4. doi: 10.1097/00007611-199104000-00025.
Calcium channel blockers are a heterogeneous group of drugs that have enhanced our ability to concurrently control blood pressure, treat coronary artery disease, and avoid many of the side effects of previously available antihypertensive agents. Patients with severe hypertension may require multiple agents for adequate control of blood pressure because of either poor control with one agent or side effects from high doses of a single agent. Laboratory investigations have shown a synergistic effect on receptor binding, as well as increased drug levels with the concurrent use of diltiazem and a dihydropyridine calcium channel blocker (nifedipine or nicardipine). It is as yet unknown whether these effects on receptor binding and increased drug levels translate into greater clinical efficacy in blood pressure control. We have reported what we believe to be the first case in which this interaction was used successfully to control previously poorly controlled hypertension, while minimizing side effects.
钙通道阻滞剂是一类异质性药物，它们提高了我们同时控制血压、治疗冠状动脉疾病以及避免许多既往可用抗高血压药物副作用的能力。重度高血压患者可能需要多种药物才能充分控制血压，原因要么是单一药物控制不佳，要么是高剂量单一药物产生副作用。实验室研究表明，地尔硫䓬与二氢吡啶类钙通道阻滞剂（硝苯地平或尼卡地平）同时使用时，对受体结合有协同作用，且药物水平升高。目前尚不清楚这些对受体结合和药物水平升高的影响是否会转化为血压控制方面更大的临床疗效。我们报告了我们认为的首例成功利用这种相互作用控制既往控制不佳的高血压，同时将副作用降至最低的病例。
