Department of Internal Medicine, Aging and Kidney Diseases, S. Orsola-Malpighi University Hospital, University of Bologna, Pad. 2-Via Albertoni 15, Bologna, Italy.
Clin Exp Hypertens. 2012;34(2):113-7. doi: 10.3109/10641963.2011.601381. Epub 2011 Oct 3.
The aim of this study is to assess the blood pressure (BP) and metabolic effects of lercanidipine when combined with other classes of first-line antihypertensive drugs in day-to-day clinical practice. For this study, we consecutively enrolled 162 patients with uncomplicated primary hypertension, who are partial responders to the treatment with lercanidipine over a period of 24 months. Patients were then allocated to the combination of lercanidipine (10-20 mg/day) with β-blockers, diuretics, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers according to compelling indications (if any) and/or suggestions of European Society of Hypertension-European Society of Cardiology (ESH-ESC) guidelines. All the enrolled patients completed the study and no adverse drug reaction was registered during the research period. The association of a second drug with lercanidipine determined an additional BP decrease of either systolic BP or diastolic BP independently from the type of drug added (P always <.05). The additional effect of lercanidipine appears widely distributed with no significant differences in the size of BP decrease. From the metabolic point of view, the addition of a second drug did not determine a significant variation in the serum levels of total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (P always >.05). Conversely, a significant decrease in fasting plasma glucose and serum levels of triglycerides has been observed in patients where lercanidipine has been combined with an angiotensin-converting enzyme inhibitor or an angiotensin-II receptor blocker. In conclusion, in our study we observed that lercanidipine-based protocols are well tolerated and efficacious in reducing BP. Moreover, the association of lercanidipine with renin-angiotensin system blockers is also associated with significant improvements in triglycerides and fasting plasma glucose.
本研究旨在评估在日常临床实践中，当与其他一线抗高血压药物联合使用时，乐卡地平对血压（BP）和代谢的影响。在这项研究中，我们连续招募了 162 名患有单纯原发性高血压的患者，这些患者在 24 个月的时间里对乐卡地平的治疗反应不完全。然后，根据强制性适应证（如果有）和/或欧洲高血压学会-欧洲心脏病学会（ESH-ESC）指南的建议，将患者分配到乐卡地平（10-20mg/天）与β受体阻滞剂、利尿剂、血管紧张素转换酶抑制剂和血管紧张素 II 受体阻滞剂联合治疗。所有入组患者均完成了研究，在研究期间未登记任何药物不良反应。与乐卡地平联合使用第二种药物可独立于添加药物的类型（P 始终<.05）使收缩压或舒张压进一步降低。乐卡地平的附加作用似乎分布广泛，降压幅度无显著差异。从代谢角度来看，添加第二种药物不会导致总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇的血清水平发生显著变化（P 始终>.05）。相反，在与血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂联合使用乐卡地平的患者中，空腹血糖和血清甘油三酯水平显著降低。总之，在我们的研究中，我们观察到基于乐卡地平的方案在降低血压方面具有良好的耐受性和疗效。此外，乐卡地平与肾素-血管紧张素系统阻滞剂联合使用还与甘油三酯和空腹血糖的显著改善相关。
