Wilkinson R, Mansy S, Corcoran C
Dept of Renal Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
Arch Mal Coeur Vaiss. 1989 Dec;82 Spec No 5:31-8.
A dissociation between the hypotensive activity and the central side effects has been demonstrated with rilmenidine (RIL) in previous studies. The object of this trial was to compare RIL with methyldopa (MD) during a 12 weeks' treatment (Day 0 to Day 84) and after stopping therapy (Day 84-Day 91). In particular, the trial was designed to evaluate the acceptability of the two agents. After 4 weeks of placebo, 76 men and 81 women (average age 55 years) were allocated according to a randomised double-blind protocol to RIL (N = 78) or MD (N = 79). The two groups were comparable with systolic/diastolic BP of 165/102 mmHg and 165/101 mmHg respectively. Monotherapy was administered to all the patients from Day 0 to Day 56 in order to compare RIL (1 mg every morning or 1 mg twice daily if necessary) and MD (250 mg morning and evening or 500 mg twice daily if necessary). Hydrochlorothiazide (25 mg daily) was associated from Day 56 to Day 84 if the supine diastolic BP was greater than or equal to 90 mmHg. A placebo was substituted from Day 84 to Day 91 to study the effect of withdrawing therapy.
at Day 56 under monotherapy, the average supine systolic/diastolic BP had decreased significantly with RIL and MD to 140/110 mmHg and 140/100 mmHg respectively. An equivalent number of patients had normalised their blood pressures in both groups (systolic/diastolic BP less than or equal to 160/90 mmHg): 50% with RIL and 42% with MD (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
在先前的研究中已证实,利美尼定(RIL)的降压活性与中枢副作用之间存在分离现象。本试验的目的是在12周治疗期(第0天至第84天)及停药后(第84天至第91天)比较RIL与甲基多巴(MD)。特别地,该试验旨在评估这两种药物的可接受性。在服用4周安慰剂后,76名男性和81名女性(平均年龄55岁)按照随机双盲方案被分配至RIL组(N = 78)或MD组(N = 79)。两组的收缩压/舒张压分别为165/102 mmHg和165/101 mmHg,具有可比性。从第0天至第56天,所有患者均接受单一疗法,以比较RIL(必要时每天早晨1 mg或每日两次,每次1 mg)和MD(早晚各250 mg或必要时每日两次,每次500 mg)。如果仰卧位舒张压大于或等于90 mmHg,则从第56天至第84天加用氢氯噻嗪(每日25 mg)。从第84天至第91天用安慰剂替代药物,以研究停药的效果。
在单一疗法治疗的第56天,RIL和MD治疗后平均仰卧位收缩压/舒张压均显著下降,分别降至140/110 mmHg和140/100 mmHg。两组中血压正常化(收缩压/舒张压小于或等于160/90 mmHg)的患者数量相当:RIL组为50%,MD组为42%(无显著性差异)。(摘要截断于250字)