Cox J P, Duggan J, O'Boyle C A, Mee F, Walsh J B, Coakley D, O'Brien E, O'Malley K
Blood Pressure Clinic, Beaumont Hospital, Dublin, Ireland.
J Hypertens. 1989 Apr;7(4):299-303.
To establish the role of angiotensin converting enzyme inhibitors in the management of hypertension in the elderly, 16 patients were treated with captopril in a randomized double-blind placebo-controlled cross-over study. Clinic blood pressure, ambulatory blood pressure, renal function and mental performance, with emphasis on mood and psychological well-being, were assessed. Twelve patients, aged 73 (+/- 4.4) years, completed the study. The doses of captopril used were 50 mg (11 patients) and 25 mg (one patient) twice daily for 4 weeks. Mean (+/- s.e.m.) clinic sitting blood pressure during captopril therapy was significantly lower than during administration of placebo (172 +/- 4.5/83 +/- 25 versus 188 +/- 4.4/89 +/- 3.4 mmHg; P less than 0.001/P less than 0.05). Mean ambulatory blood pressure was also significantly lower on captopril treatment than during administration of placebo (166 +/- 5.3/87 +/- 1.6 versus 179 +/- 5.1/94 +/- 2.4 mmHg; P less than 0.02/P less than 0.02) and this effect was sustained over the dosing interval. Renal blood flow and mental performance were unaltered by treatment. Gastrointestinal discomfort occurred in two patients, one of whom was withdrawn and cough developed in one patient. We conclude that captopril is effective as monotherapy in lowering blood pressure in the elderly.
为确定血管紧张素转换酶抑制剂在老年高血压治疗中的作用，在一项随机双盲安慰剂对照交叉研究中，对16例患者使用卡托普利进行治疗。评估了临床血压、动态血压、肾功能和心理表现，重点是情绪和心理健康。12例年龄为73（±4.4）岁的患者完成了研究。所用卡托普利的剂量为每日两次，50mg（11例患者）和25mg（1例患者），共4周。卡托普利治疗期间的平均（±标准误）临床坐位血压显著低于服用安慰剂期间（172±4.5/83±2.5对188±4.4/89±3.4mmHg；P<0.001/P<0.05）。卡托普利治疗时的平均动态血压也显著低于服用安慰剂期间（166±5.3/87±1.6对179±5.1/94±2.4mmHg；P<0.02/P<0.02），且这种效果在给药间隔期持续存在。治疗对肾血流量和心理表现无影响。2例患者出现胃肠道不适，其中1例退出研究，1例患者出现咳嗽。我们得出结论，卡托普利作为单一疗法在降低老年患者血压方面是有效的。
