Franz I W, Tönnesmann U, Behr U, Ketelhut R
Klinik Wehrawald der BfA, Todtmoos, Federal Republic of Germany.
Cardiovasc Drugs Ther. 1989 Jun;3 Suppl 1:313-7. doi: 10.1007/BF00148476.
Fourteen patients with previously untreated essential hypertension and left ventricular hypertrophy were treated with a fixed-dose combination of acebutolol 200 mg and nifedipine 20 mg once daily for a followup of 25.6 +/- 1.8 months. Echocardiography showed a significant decrease after a mean period of 6.6 months in interventricular septal thickness (14.8%, p less than 0.001), posterior wall thickness (14.8%, p less than 0.001), and left ventricular mass index (21.3%). After 25.6 months, the reductions were 29% (p less than 0.001), 28.1% (p less than 0.001), and 38.7% (p less than 0.001), respectively. Left wall thickness was significantly reduced, but left ventricular end-systolic and end-diastolic dimensions and fractional shortening remained unchanged. Treatment reduced resting blood pressure from 161/102 mmHg to 132/87 mmHg (p less than 0.001) and reduced exercise blood pressure at 100 W from 208/113 mmHg to 170/94 mmHg (p less than 0.001). Thus, nifedipine in combination with acebutolol produces significant blood-pressure reduction accompanied by regression of left ventricular hypertrophy without noticeable changes in left ventricular function.
14例未经治疗的原发性高血压伴左心室肥厚患者接受醋丁洛尔200mg与硝苯地平20mg固定剂量联合治疗,每日1次,随访25.6±1.8个月。超声心动图显示,平均6.6个月后,室间隔厚度(14.8%,p<0.001)、后壁厚度(14.8%,p<0.001)和左心室质量指数(21.3%)显著降低。25.6个月后,降低幅度分别为29%(p<0.001)、28.1%(p<0.001)和38.7%(p<0.001)。左室壁厚度显著降低,但左心室收缩末期和舒张末期内径以及缩短分数保持不变。治疗使静息血压从161/102mmHg降至132/87mmHg(p<0.001),并使100W运动血压从208/113mmHg降至170/94mmHg(p<0.001)。因此,硝苯地平与醋丁洛尔联合使用可显著降低血压,并伴有左心室肥厚的消退,而左心室功能无明显变化。