Carpenè G, Rocco S, Opocher G, Mantero F
Institute of Semeiotica Medica, University of Padova, Italy.
Clin Exp Hypertens A. 1989;11(7):1263-72. doi: 10.3109/10641968909038169.
Since calcium entry blocker drugs can interfere with aldosterone secretion in vitro, a similar effect in vivo, in man, has been suggested and partially confirmed. The data available in primary aldosteronism are more controversial. Therefore, we have studied the acute and chronic effect of nifedipine in 7 patients with idiopathic hyperaldosteronism (IHA) and 8 with aldosterone producing adenoma (APA). On 2 different days, 10 mg of nifedipine or placebo were given sublingually to the patients and blood pressure and heart rate were recorded every 5 min. for 60 min. Plasma aldosterone, cortisol, PRA and serum K+ were measured at 0, 30 and 60 min. 5 patients with IHA and 6 with APA received nifedipine 20 mg per os bid for 3 months; the same parameters were evaluated on days 0, 30, 60 and 90; urinary aldosterone was measured on days 0, 30, 60 and 90. BP decreased in both groups both after acute and chronic administration of nifedipine. Plasma aldosterone showed a similar trend either after acute nifedipine or placebo; however, during chronic treatment it was slightly decreased in IHA patients. Cortisol, PRA, urinary aldosterone and K+ remained unchanged. In conclusion, nifedipine is an effective antihypertensive agent also in primary aldosteronism; its aldosterone inhibiting properties are minimal and seem to be present only during long-term therapy in IHA.
由于钙通道阻滞剂药物在体外可干扰醛固酮分泌，因此有人提出并部分证实了其在人体体内有类似作用。原发性醛固酮增多症方面的现有数据更具争议性。因此，我们研究了硝苯地平对7例特发性醛固酮增多症（IHA）患者和8例醛固酮瘤（APA）患者的急性和慢性影响。在2个不同的日子里，给患者舌下含服10mg硝苯地平或安慰剂，每5分钟记录一次血压和心率，共记录60分钟。在0、30和60分钟时测量血浆醛固酮、皮质醇、肾素活性（PRA）和血清钾。5例IHA患者和6例APA患者口服硝苯地平20mg，每日2次，共3个月；在第0、30、60和90天评估相同参数；在第0、30、60和90天测量尿醛固酮。急性和慢性给予硝苯地平后，两组血压均下降。急性给予硝苯地平或安慰剂后，血浆醛固酮呈现相似趋势；然而，在慢性治疗期间，IHA患者的血浆醛固酮略有下降。皮质醇、PRA、尿醛固酮和钾保持不变。总之，硝苯地平在原发性醛固酮增多症中也是一种有效的抗高血压药物；其醛固酮抑制特性极小，似乎仅在IHA的长期治疗期间存在。
