McInnes G T, Findlay I N, Murray G, Cleland J G, Dargie H J
University Department of Medicine, Gardiner Institute, Western Infirmary, Glasgow, Scotland, UK.
J Hypertens Suppl. 1985 Dec;3(3):S219-21.
Since there is concern that the potentially useful antihypertensive combination of verapamil and propranolol might lead to adverse cardiovascular responses, we have investigated its effects, not only on blood pressure, but also on electrocardiographic and echocardiographic variables. Fourteen hypertensive patients participated in a double-blind, randomized, crossover comparison of verapamil 360 mg, propranolol 240 mg, verapamil 360 mg + propranolol 240 mg, and placebo, each given for 4 weeks. The antihypertensive effect of verapamil + propranolol was greater than that of either drug alone. Pulse rate was reduced by propranolol but not verapamil. However, addition of verapamil to propranolol led to further reduction in pulse rate. The PR interval was prolonged by verapamil + propranolol when compared with all other treatments. The active drugs increased ventricular dimensions and the effect of the combination was statistically significant. Thus, verapamil + propranolol is an effective antihypertensive combination, but heart rate, atrio-ventricular conduction and left ventricular function may be affected adversely, necessitating careful monitoring of therapy.
由于有人担心维拉帕米和普萘洛尔这两种潜在有用的抗高血压药物联合使用可能会导致不良心血管反应，我们不仅研究了其对血压的影响，还研究了其对心电图和超声心动图变量的影响。14名高血压患者参与了一项双盲、随机、交叉对照试验，比较了维拉帕米360毫克、普萘洛尔240毫克、维拉帕米360毫克+普萘洛尔240毫克以及安慰剂的效果，每种药物均服用4周。维拉帕米+普萘洛尔的降压效果大于单独使用任何一种药物。普萘洛尔可降低脉搏率，但维拉帕米无此作用。然而，在普萘洛尔基础上加用维拉帕米可进一步降低脉搏率。与所有其他治疗相比，维拉帕米+普萘洛尔可延长PR间期。活性药物会增加心室大小，且联合用药的效果具有统计学意义。因此，维拉帕米+普萘洛尔是一种有效的抗高血压联合用药，但可能会对心率、房室传导和左心室功能产生不良影响，因此需要仔细监测治疗情况。
