Chalmers J, Wing L, West M, Bune A, Johnston C, Jackson B, McGrath B, Mashford M L, Heath W, Westwood B
Flinders Medical Centre, South Australia.
J Cardiovasc Pharmacol. 1987;10 Suppl 10:S82-4.
Felodipine was compared with prazosin in patients with essential hypertension whose blood pressure was not controlled by a beta-blocking drug. One hundred patients with a supine diastolic blood pressure greater than or equal to mm Hg after 4 weeks or more on a beta-blocking drug and placebo were randomly assigned to felodipine or prazosin tablets. The drugs were titrated at 2-week intervals if diastolic BP was greater than or equal to 90 mm Hg. Titration steps of felodipine were 5, 10, 20 mg b.i.d. and of prazosin were 1, 2, 4 mg b.i.d. The fall in blood pressure with felodipine 32/21 mm Hg was greater than the fall with prazosin 16/12 mm Hg (p less than 0.001); 36 patients achieved a diastolic blood pressure of less than 90 mm Hg with felodipine, which was a significantly greater number than the 20 patients who obtained such a level with prazosin (p less than 0.01). Both drugs were well tolerated, but more patients complained of vascular type side effects (flushing, peripheral edema) with felodipine than with prazosin. There was significant weight gain with prazosin but not with felodipine. Felodipine was shown to be a well-tolerated, effective antihypertensive agent when used with a beta-blocking drug and to be suitable for people with hypertension who fail to be controlled with a beta-blocking drug.
在血压未被β受体阻滞剂控制的原发性高血压患者中，对非洛地平与哌唑嗪进行了比较。100例在服用β受体阻滞剂和安慰剂4周或更长时间后仰卧位舒张压大于或等于[此处原文缺失具体数值]mmHg的患者，被随机分配至非洛地平组或哌唑嗪组服用片剂。如果舒张压大于或等于90mmHg，则每2周调整一次药物剂量。非洛地平的滴定步骤为每日两次，每次5、10、20mg；哌唑嗪的滴定步骤为每日两次，每次1、2、4mg。非洛地平使血压下降32/21mmHg，大于哌唑嗪使血压下降的16/12mmHg（p<0.001）；36例患者使用非洛地平后舒张压降至90mmHg以下，显著多于使用哌唑嗪达到此水平的20例患者（p<0.01）。两种药物耐受性均良好，但与哌唑嗪相比，更多使用非洛地平的患者抱怨有血管型副作用（潮红、外周水肿）。服用哌唑嗪后体重有显著增加，而非洛地平则没有。结果表明，非洛地平与β受体阻滞剂联用时是一种耐受性良好、有效的抗高血压药物，适用于使用β受体阻滞剂无法控制血压的高血压患者。
