Laher M S, Donohoe J F, Kelly J G, Doyle G D
Department of Medicine and Pathology, James Connolly Hospital, Dublin, Ireland.
Am J Med. 1988 Sep 23;85(3B):38-43. doi: 10.1016/0002-9343(88)90349-x.
The antihypertensive efficacy and safety of lisinopril were assessed in 60 older patients with a mean age of 75 years (range, 65 to 85 years) in a 12-week open study. Mean ( +/- SEM) blood pressure while sitting was reduced from 190/106 +/- 3.3/1.8 mm Hg at entry to 162/89 +/- 3.2/1.6 mm Hg after 12 weeks of treatment (p less than 0.001). There was no significant alteration in heart rate, and postural hypotension did not occur. Mean glomerular filtration rate at entry was 61.6 +/- 3.4 ml/minute and was unchanged after 12 weeks of therapy at 62.2 +/- 3.0 ml/minute. Fourteen patients continued to receive lisinopril for a period of one year. Blood pressure remained controlled throughout and heart rate remained unchanged. There was a significant reduction in mean arterial pressure from 128.8 +/- 1.9 mm Hg to 105.1 +/- 1.5 mm Hg (p less than 0.001). Biochemical parameters remained unaltered. There was a significant increase in renal blood flow (p less than 0.025) and a corresponding reduction in renovascular resistance (p less than 0.001) following long-term therapy with lisinopril. Thus, lisinopril was generally well-tolerated and highly effective in lowering blood pressure in older hypertensive patients, whereas at the same time renal function was not adversely changed.
在一项为期12周的开放性研究中，对60名平均年龄为75岁（范围65至85岁）的老年患者评估了赖诺普利的降压疗效和安全性。治疗前坐位时平均（±标准误）血压为190/106±3.3/1.8 mmHg，治疗12周后降至162/89±3.2/1.6 mmHg（p<0.001）。心率无显著变化，且未发生体位性低血压。治疗前平均肾小球滤过率为61.6±3.4 ml/分钟，治疗12周后为62.2±3.0 ml/分钟，无变化。14名患者继续接受赖诺普利治疗1年。血压在整个期间保持受控，心率保持不变。平均动脉压从128.8±1.9 mmHg显著降至105.1±1.5 mmHg（p<0.001）。生化指标保持不变。长期使用赖诺普利治疗后，肾血流量显著增加（p<0.025），肾血管阻力相应降低（p<0.001）。因此，赖诺普利在老年高血压患者中通常耐受性良好且降压效果显著，同时肾功能未受到不利影响。
