Weir M R, Cassidy C A, Hall P S, Lancaster A, Schubert C, Urick A, Saunders E, Kong B W, Jenkins P, Lavin P T
Division of Nephrology, University of Maryland Hospital, Baltimore.
Clin Ther. 1990 Mar-Apr;12(2):139-48.
The study involved 113 patients over age 50 years with mild to moderate essential hypertension, randomly assigned to treatment with enalapril (n = 54) or sustained-release verapamil (n = 59). During an eight-week titration period, doses were adjusted to achieve supine diastolic blood pressures (DBP) below 90 mmHg; patients were then given maintenance doses for eight weeks. Mean blood pressures were reduced significantly from 147.7/93.9 mmHg at baseline to 137.7/84.5 mmHg at the end of the maintenance period in the enalapril group and from 155.1/95.1 to 142.4/86.2 mmHg in the verapamil group. In the patients who completed treatment, the mean daily doses required to maintain DBP below 90 mmHg were 9.6 mg of enalapril and 244.9 mg of verapamil. There were 11 treatment failures in the enalapril group and 22 in the verapamil group: eight of the enalapril and 17 of the verapamil patients did not attain goal blood pressures and three and five were withdrawn because of side effects. It is concluded that both enalapril and sustained-release verapamil were generally effective and well tolerated in the treatment of mild to moderate hypertension in the middle-aged and older patients.
该研究纳入了113例年龄超过50岁的轻度至中度原发性高血压患者，随机分配接受依那普利治疗（n = 54）或缓释维拉帕米治疗（n = 59）。在为期8周的滴定期内，调整剂量以使仰卧位舒张压（DBP）低于90 mmHg；然后给予患者维持剂量8周。依那普利组的平均血压从基线时的147.7/93.9 mmHg显著降至维持期末的137.7/84.5 mmHg，维拉帕米组则从155.1/95.1 mmHg降至142.4/86.2 mmHg。在完成治疗的患者中，将DBP维持在90 mmHg以下所需的平均每日剂量为依那普利9.6 mg和维拉帕米244.9 mg。依那普利组有11例治疗失败，维拉帕米组有22例：依那普利组的8例和维拉帕米组的17例患者未达到目标血压，3例和5例因副作用退出。结论是，依那普利和缓释维拉帕米在治疗中老年患者的轻度至中度高血压方面总体上有效且耐受性良好。
