Bidiville J, Nussberger J, Waeber G, Porchet M, Waeber B, Brunner H R
Hypertension Division, Centre Hospitalier Universitaire, Lausanne, Switzerland.
Hypertension. 1988 Feb;11(2):166-73. doi: 10.1161/01.hyp.11.2.166.
This study was designed to assess whether the acute blood pressure response of an individual hypertensive patient to a calcium antagonist or an angiotensin converting enzyme (ACE) inhibitor is a good predictor of the long-term efficacy of these drug classes in this particular patient. The concept that good responses to ACE inhibitors and calcium antagonists may be mutually exclusive was also tested. Sixteen patients were included in a randomized crossover trial of enalapril, 20 mg daily, and diltiazem, 120 mg daily, for 6 weeks each. Blood pressure was measured by ambulatory blood pressure recording. During the washout phase, the acute effect of nifedipine, 10 mg p.o., and enalaprilat, 5 mg i.v., was evaluated. Nifedipine and enalaprilat reduced blood pressure equally well. The long-term blood pressure reduction induced by enalapril and diltiazem was similar. The acute blood pressure response to a given drug was not a good predictor of the result obtained with long-term therapy. No age dependency of the antihypertensive effect of either drug class was apparent. There was no evidence that a good response to one drug excluded a similarly good response to the other.
本研究旨在评估个体高血压患者对钙拮抗剂或血管紧张素转换酶（ACE）抑制剂的急性血压反应是否能很好地预测这些药物类别对该特定患者的长期疗效。同时也对ACE抑制剂和钙拮抗剂的良好反应可能相互排斥这一概念进行了测试。16名患者参与了一项随机交叉试验，分别服用每日20毫克依那普利和每日120毫克地尔硫䓬，各为期6周。通过动态血压记录来测量血压。在洗脱期，评估了口服10毫克硝苯地平和静脉注射5毫克依那普利拉的急性效应。硝苯地平和依那普利拉降低血压的效果相当。依那普利和地尔硫䓬引起的长期血压降低相似。对给定药物的急性血压反应并不能很好地预测长期治疗的结果。两种药物类别的降压效果均未表现出年龄依赖性。没有证据表明对一种药物的良好反应会排除对另一种药物同样良好的反应。
