St. James Hospital, Dublin, Ireland.
Int J Geriatr Psychiatry. 2011 Oct;26(10):1038-45. doi: 10.1002/gps.2638. Epub 2010 Oct 29.
Nilvadipine may lower rates of conversion from mild-cognitive impairment to Alzheimer's disease (AD), in hypertensive patients. However, it remains to be determined whether treatment with nilvadipine is safe in AD patients, given the higher incidence of orthostatic hypotension (OH) in this population, who may be more likely to suffer from symptoms associated with the further exaggeration of a drop in BP.
The aim of this study was to investigate the safety and tolerability of nilvadipine in AD patients.
AD patients in the intervention group (n = 56) received nilvadipine 8 mg daily over 6-weeks, compared to the control group (n = 30) who received no intervention. Differences in systolic (SBP) and diastolic (DBP) blood pressure, before and after intervention, was assessed using automated sphygmomanometer readings and ambulatory BP monitors (ABP), and change in OH using a finometer. Reporting of adverse events was monitored throughout the study.
There was a significant reduction in the SBP of treated patients compared to non-treated patients but no significant change in DBP. Individuals with higher initial blood pressure (BP) had greater reduction in BP but individuals with normal BP did not experience much change in their BP. While OH was present in 84% of the patients, there was no further drop in BP recorded on active stand studies. There were no significant differences in adverse event reporting between groups.
Nilvadipine was well tolerated by patients with AD. This study supports further investigation of its efficacy as a potential treatment for AD.
尼伐地平可能会降低高血压患者轻度认知障碍向阿尔茨海默病（AD）转化的比率。然而，鉴于 AD 患者体位性低血压（OH）的发生率较高，他们可能更容易出现与血压进一步下降相关的症状，因此需要确定尼伐地平在 AD 患者中的治疗安全性。
本研究旨在探讨尼伐地平治疗 AD 患者的安全性和耐受性。
干预组（n=56）AD 患者接受尼伐地平 8mg 每日治疗 6 周，对照组（n=30）未接受干预。使用自动血压计读数和动态血压监测仪（ABP）评估干预前后收缩压（SBP）和舒张压（DBP）的差异，并使用 finometer 评估 OH 的变化。在整个研究过程中监测不良事件的报告。
与未治疗患者相比，治疗患者的 SBP 显著降低，但 DBP 无显著变化。初始血压较高的个体血压下降幅度更大，但血压正常的个体血压变化不大。尽管 84%的患者存在 OH，但在主动站立研究中未记录到 BP 进一步下降。两组之间不良事件报告无显著差异。
尼伐地平在 AD 患者中耐受性良好。本研究支持进一步研究其作为 AD 潜在治疗方法的疗效。
