Persson B, Andersson O K, Wysocki M, Hedner T, Aurell M
Department of Medicine I, Sahlgrenska Hospital, University of Gothenburg, Sweden.
Am J Med. 1989 Apr 17;86(4A):60-4. doi: 10.1016/0002-9343(89)90192-7.
Twenty-three men with essential hypertension participated in a double-blind placebo-controlled study with a crossover design to evaluate the long-term (nine weeks) effects of isradipine on central and renal hemodynamics. Isradipine as monotherapy was titrated from 2.5 to 5 and then to 7.5 mg twice daily. At the end of the crossover periods, cardiac output (dye-dilution) and intraarterial blood pressure were assessed. Compared with placebo, isradipine reduced ambulatory blood pressure from 174/104 to 154/91 (p less than 0.001), whereas the heart rate was unchanged. The reduction of blood pressure was entirely due to a reduction (36 percent; p less than 0.001) of the peripheral resistance. The baroreceptor sensitivity did not change (RR intervals during infusion of phenylephrine) but, with isradipine, the setpoint was shifted to lower blood pressure levels. Renal plasma flow (para-amino hippurate clearance) increased (465 versus 391 ml/minute; p less than 0.05), but glomerular filtration rate ([51Cr]ethylenediaminetetraacetic acid clearance) did not change. Hence, the filtration fraction decreased. With isradipine, there was a post-dose increase in natriuresis (0.45 to 0.34 mmol/minute; p = 0.06). Side effects were mild.
23名原发性高血压男性患者参与了一项采用交叉设计的双盲安慰剂对照研究，以评估伊拉地平对中枢和肾脏血流动力学的长期（9周）影响。伊拉地平作为单一疗法，剂量从每日2次2.5毫克滴定至5毫克，然后再滴定至7.5毫克。在交叉期结束时，评估心输出量（染料稀释法）和动脉内血压。与安慰剂相比，伊拉地平使动态血压从174/104降至154/91（p<0.001），而心率未改变。血压降低完全归因于外周阻力降低（36%；p<0.001）。压力感受器敏感性未改变（去氧肾上腺素输注期间的RR间期），但使用伊拉地平时，调定点移至更低血压水平。肾血浆流量（对氨基马尿酸清除率）增加（465对391毫升/分钟；p<0.05），但肾小球滤过率（[51Cr]乙二胺四乙酸清除率）未改变。因此，滤过分数降低。使用伊拉地平时，给药后钠尿排泄增加（从0.45至0.34毫摩尔/分钟；p=0.06）。副作用轻微。
