Weir M R, Haynie R, Vertes V, Pinson R, Kong B W, Jenkins P, Lavin P T
Division of Nephrology, University of Maryland Hospital, Baltimore.
Clin Ther. 1990 Nov-Dec;12(6):473-81.
The subjects of this multicenter study were 159 patients aged 21 to 76 years with mild to moderate uncomplicated essential hypertension. The patients were randomly assigned to receive up to 40 mg of enalapril daily or 360 mg of sustained-release diltiazem daily for a titration period of eight weeks and then maintenance doses for four weeks. The treatment goal was a supine diastolic blood pressure of less than 90 mmHg or a fall of at least 10 mmHg from baseline. During titration, 62% of the enalapril-treated patients and 51% of the diltiazem-treated patients reached the treatment goal after two weeks, 82% and 74% after four weeks, 87% and 84% after six weeks, and 92% and 87% after eight weeks. During the maintenance period, 85% of the enalapril-treated and 87% of the diltiazem-treated patients maintained the goal blood pressure. Treatment side effects were reported by 21% of the enalapril-treated patients and 29% of the diltiazem-treated patients; treatment was discontinued in two patients from each group because of side effects. It is concluded that both drugs were generally well tolerated and effective in the treatment of adult mild to moderate essential hypertension.
这项多中心研究的受试者为159名年龄在21至76岁之间、患有轻度至中度单纯性原发性高血压的患者。患者被随机分配，在为期8周的滴定期内，每日接受最多40毫克依那普利或每日360毫克缓释地尔硫䓬治疗，然后进行为期4周的维持剂量治疗。治疗目标是仰卧位舒张压低于90毫米汞柱或较基线水平至少下降10毫米汞柱。在滴定期间，接受依那普利治疗的患者中有62%、接受地尔硫䓬治疗的患者中有51%在两周后达到治疗目标，四周后分别为82%和74%，六周后为87%和84%，八周后为92%和87%。在维持期，接受依那普利治疗的患者中有85%、接受地尔硫䓬治疗的患者中有87%维持了目标血压。接受依那普利治疗的患者中有21%、接受地尔硫䓬治疗的患者中有29%报告了治疗副作用；每组均有两名患者因副作用而停药。结论是，两种药物在治疗成人轻度至中度原发性高血压方面总体耐受性良好且有效。
