Saha Lekha, Shekhar Gautam Chander
Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
ISRN Gastroenterol. 2011;2011:757141. doi: 10.5402/2011/757141. Epub 2010 Nov 7.
The prevalence of hypertension increases with advancing age. The management of hypertension especially in the elderly has its own limitations. Verapamil is not recommended in the elderly on account of high incidences of troublesome constipation. Amlodipine has become very popular with the cardiologists and general physicians. Survey of literature has not yielded any citation where the troublesome effect of amlodipine on the gastrointestinal tract has been reported. In an experimental study on isolated rabbit intestine we have demonstrated that amlodipine dose-dependently inhibit the spontaneous activity of the intestinal tract. With this background the present observational study was planned. A total of 100 hypertensive patients were included in the present study. Fifty patients were on amlodipine alone and 50 patients on combination of amlodipine and atenolol. The main parameter analyzed was the frequency and consistency of stool before and after intake of drug. The relative risk (RR) of developing constipation was 4.00 with 95% CI 0.8930 to 17.917 in amlodipine alone group. From this study it can be concluded that the relative risk of developing constipation is 4 times more in patients who are taking amlodipine alone as compared to those patients who are on combination of amlodipine and atenolol.
高血压的患病率随年龄增长而增加。高血压的治疗，尤其是老年患者的治疗有其自身的局限性。由于便秘发生率高，维拉帕米不推荐用于老年患者。氨氯地平在心脏病专家和普通内科医生中非常受欢迎。文献调查未发现有任何关于氨氯地平对胃肠道不良影响的报道。在一项对离体兔肠的实验研究中，我们证明氨氯地平剂量依赖性地抑制肠道的自发活动。在此背景下，开展了本观察性研究。本研究共纳入100例高血压患者。50例患者单独使用氨氯地平，50例患者联合使用氨氯地平和阿替洛尔。分析的主要参数是服药前后大便的频率和稠度。单独使用氨氯地平组发生便秘的相对风险（RR）为4.00，95%置信区间为0.8930至17.917。从本研究可以得出结论，与联合使用氨氯地平和阿替洛尔的患者相比，单独服用氨氯地平的患者发生便秘的相对风险高出4倍。
