Gilchrist N L, Nicholls M G, Ewer T C, Livesey J H, Sainsbury R
Department of Geriatric Medicine, Princess Margaret Hospital, Christchurch, New Zealand.
J Hum Hypertens. 1988 Jun;2(1):33-9.
The effects of nifedipine and enalapril on blood pressure (BP), heart rate, plasma and urine electrolyte, plasma renin activity (PRA), aldosterone and catecholamines, were studied in ten elderly hypertensive subjects in a randomised, single-blind, cross-over trial. Both nifedipine and enalapril were effective in lowering supine and erect systolic and diastolic BP, with nifedipine causing a significant (P less than 0.05) rise in heart rate. Arterial pressure rose to pre-treatment levels on withdrawal of both drugs. Plasma glucose fell significantly (P less than 0.02) on enalapril therapy, whilst no other biochemical changes were observed. PRA, aldosterone and adrenaline rose on nifedipine therapy whereas PRA showed a greater rise on enalapril with a fall in plasma aldosterone and no change in plasma adrenaline. Plasma noradrenaline was not altered by either agent. Unacceptable side effects occurred in patients taking nifedipine resulting in discontinuation of therapy in 2 patients and death in another. Nifedipine or enalapril monotherapy is effective in lowering BP in the elderly hypertensives. Although more experience is needed, the side effect profile of both agents especially enalapril, appears satisfactory.
在一项随机、单盲、交叉试验中，对10名老年高血压患者研究了硝苯地平和依那普利对血压（BP）、心率、血浆和尿液电解质、血浆肾素活性（PRA）、醛固酮和儿茶酚胺的影响。硝苯地平和依那普利均可有效降低仰卧位和直立位收缩压和舒张压，硝苯地平可使心率显著（P<0.05）升高。停用两种药物后，动脉血压回升至治疗前水平。依那普利治疗期间血浆葡萄糖显著下降（P<0.02），未观察到其他生化变化。硝苯地平治疗时PRA、醛固酮和肾上腺素升高，而依那普利治疗时PRA升高幅度更大，血浆醛固酮下降，血浆肾上腺素无变化。两种药物均未改变血浆去甲肾上腺素水平。服用硝苯地平的患者出现了无法耐受的副作用，导致2例患者停药，另1例死亡。硝苯地平或依那普利单药治疗对老年高血压患者有效。尽管还需要更多经验，但两种药物尤其是依那普利的副作用情况似乎令人满意。
