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双醋洛尔治疗原发性高血压的疗效与安全性评估

[Evaluation of the efficacy and safety of dilevalol in the treatment of essential arterial hypertension].

作者信息

Bochicchio T, Pérez-Grovas H A, Carrizosa J, Herrera-Acosta J

机构信息

Servicio de Nefrología del Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.

出版信息

Arch Inst Cardiol Mex. 1989 Mar-Apr;59(2):181-6.

PMID:2569857
Abstract

Dilevalol, an optical isomer of labetalol, combines beta-blocking and vasodilator actions which prevent reflex tachycardia and it also has intrinsic beta-2-agonist action. Its low alpha-blocking action prevents orthostatic hypotension and improves first dose tolerance. The present study evaluates the efficacy and safety of dilevalol comparing it with captopril and nifedipine. Fifty-eight mild to moderate essential hypertensive patients were studied. After a 2 to 3 week placebo lead-in phase, patients with diastolic blood pressure between 95 and 105 mmHg were included., Patients were randomly assigned to one of the 3 study drugs for a 4-week period. Initially, 15 patients received dilevalol 200 mg qd and 15 captopril 100 mg bid; afterwards, 14 received dilevalol 200 mg qd and 14 nifedipine 40 mg bid. In the first group dilevalol decreased mean blood pressure (MBP) from 118.0 +/- 1.3 to 107.3 +/- 2.7 mmHg at week 4 and captopril from 117.8 +/- 1.2 to 108.6 +/- 2.7 (p less than 0.05). When dilevalol and nifedipine were compared, the former decreased MBP from 116.0 +/- 2.0 to 104.3 +/- 3.2 mmHg and the latter from 115.0 +/- 1.4 to 106.0 +/- 3.0 (p less than 0.05). The drug was well tolerated without evidence of orthostatic hypotension. Our results demonstrate that dilevalol is as safe and effective as captopril and nifedipine for the treatment of essential hypertension.

摘要

地来洛尔是拉贝洛尔的光学异构体,兼具β受体阻滞和血管舒张作用,可预防反射性心动过速,还具有内在的β2激动剂作用。其较弱的α受体阻滞作用可预防体位性低血压并提高首剂耐受性。本研究对地来洛尔与卡托普利和硝苯地平比较的疗效和安全性进行了评估。对58例轻度至中度原发性高血压患者进行了研究。在2至3周的安慰剂导入期后,纳入舒张压在95至105 mmHg之间的患者。患者被随机分配至三种研究药物之一,为期4周。最初,15例患者接受地来洛尔200 mg每日一次,15例接受卡托普利100 mg每日两次;之后,14例接受地来洛尔200 mg每日一次,14例接受硝苯地平40 mg每日两次。在第一组中,地来洛尔在第4周时将平均血压(MBP)从118.0±1.3降至107.3±2.7 mmHg,卡托普利从117.8±1.2降至108.6±2.7(p<0.05)。比较地来洛尔和硝苯地平时,前者将MBP从116.0±2.0降至104.3±3.2 mmHg,后者从115.0±1.4降至106.0±3.0(p<0.05)。该药物耐受性良好,无体位性低血压证据。我们的结果表明,地来洛尔在治疗原发性高血压方面与卡托普利和硝苯地平一样安全有效。

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