Heber M E, Broadhurst P A, Brigden G S, Raftery E B
Cardiology Department, Northwick Park Hospital, Harrow, Middlesex, United Kingdom.
Am J Cardiol. 1990 Nov 15;66(17):1228-32. doi: 10.1016/0002-9149(90)91105-f.
The efficacy of the new once-daily dihydropyridine calcium antagonist, lacidipine, in reducing ambulatory intraarterial blood pressure (BP) was examined in 12 untreated hypertensive patients. The intraarterial recording was commenced 24 hours before the first 4-mg dose and was continued for a further 24 hours thereafter. After dose titration and chronic therapy, a second 24-hour ambulatory BP recording was made. There was a steady onset of drug action, maximal at 2 hours, but with reflex tachycardia after the first dose. Chronic administration reduced BP throughout the 24-hour period, without tachycardia. Mean daytime reduction in BP was 20 mm Hg systolic (p less than 0.005) and 12 mm Hg diastolic (p less than 0.02). Mean nighttime reduction was 8-mm Hg systolic (p less than 0.05) and 6-mm Hg diastolic (difference not significant). There was no postural decrease in BP on 60 degrees head-up tilting and hypotensive action was maintained during isometric exercise (reduction at peak of 32/18 mm Hg, p less than 0.05) and throughout dynamic exercise (reduction at peak of 23/14 mm Hg, p less than 0.05). Lacidipine is an effective once-daily antihypertensive agent, with good control of stress response.
在12例未经治疗的高血压患者中，对新型每日一次二氢吡啶类钙拮抗剂拉西地平降低动态动脉血压（BP）的疗效进行了研究。在首次服用4毫克剂量前24小时开始进行动脉内血压记录，并在之后再持续24小时。在剂量滴定和长期治疗后，进行了第二次24小时动态血压记录。药物作用起效平稳，2小时时达到最大，但首剂后出现反射性心动过速。长期给药在24小时内均降低血压，且无心动过速。白天平均收缩压降低20毫米汞柱（p<0.005），舒张压降低12毫米汞柱（p<0.02）。夜间平均收缩压降低8毫米汞柱（p<0.05），舒张压降低6毫米汞柱（差异无统计学意义）。头向上倾斜60度时血压无体位性下降，等长运动期间降压作用持续存在（峰值时降低32/18毫米汞柱，p<0.05），动态运动全程降压作用持续存在（峰值时降低23/14毫米汞柱，p<0.05）。拉西地平是一种有效的每日一次降压药物，能很好地控制应激反应。
