Schmitz A, Pedersen M M, Mogensen C E
Second University Clinic of Internal Medicine Kommunehospitalet, Aarhus, Denmark.
Am J Hypertens. 1990 Aug;3(8 Pt 1):611-7. doi: 10.1093/ajh/3.8.611.
The effect of a blood pressure reduction by 10 mg extended release felodipine once daily on urinary albumin excretion (UAE) as well as the possible diabetogenic effect of felodipine was studied. A 2 X 12 week placebo-controlled double-blind crossover study was performed in 12 hypertensive non-insulin-dependent diabetic (NIDDM) patients without nephropathy on concomitant treatment with beta-blocker and/or a diuretic agent. Metabolic control as estimated by fasting plasma glucose, hemoglobin A1c and fasting plasma C-peptide was unaltered after felodipine. Blood pressure was significantly reduced by felodipine: systolic 166 +/- 26 mm Hg (placebo) v 153 +/- 26 mm Hg (felodipine) (P less than .05) and diastolic 95 +/- 7 mm Hg v 90 +/- 8 mm Hg (P less than .05). Heart rate was unchanged. There was no correlation between blood pressure and UAE, but the relative change in UAE expressed as UAE placebo/UAE felodipine was significantly correlated to the fall in systolic blood pressure (r = 0.64, P = .03) and mean blood pressure (r = 0.66, P = .02). Since microalbuminuria predicts proteinuria and reduced survival, early antihypertensive treatment may be beneficial in NIDDM as it is in IDDM. Long-term consequences on kidney function and mortality remains, however, to be elucidated.
研究了每日一次服用10毫克缓释非洛地平降低血压对尿白蛋白排泄（UAE）的影响以及非洛地平可能的致糖尿病作用。对12名无肾病的高血压非胰岛素依赖型糖尿病（NIDDM）患者进行了一项2×12周的安慰剂对照双盲交叉研究，这些患者同时接受β受体阻滞剂和/或利尿剂治疗。服用非洛地平后，通过空腹血糖、糖化血红蛋白A1c和空腹血浆C肽评估的代谢控制未发生改变。非洛地平显著降低了血压：收缩压从166±26毫米汞柱（安慰剂）降至153±26毫米汞柱（非洛地平）（P<0.05），舒张压从95±7毫米汞柱降至90±8毫米汞柱（P<0.05）。心率未改变。血压与UAE之间无相关性，但以UAE安慰剂/UAE非洛地平表示的UAE相对变化与收缩压下降（r = 0.64，P = 0.03）和平均血压下降（r = 0.66，P = 0.02）显著相关。由于微量白蛋白尿可预测蛋白尿和生存率降低，早期抗高血压治疗在NIDDM中可能与在IDDM中一样有益。然而，对肾功能和死亡率的长期影响仍有待阐明。
