Stornello M, Pedrinelli R, Valvo E, Scapellato L, Salvetti A
Centro Ipertensione, Ospedale Generale, Siracusa, Italy.
J Hypertens Suppl. 1985 Dec;3(3):S227-9.
Acute administration of nifedipine (NIF), a calcium entry blocker (CEB), in animals reduces the hypotensive effect of clonidine (CLN), an alpha-adrenergic agonist. In order to evaluate possible negative interactions between NIF and CLN in man during chronic treatment with these drugs, 12 patients with mild to moderate uncomplicated essential hypertension received either NIF (20 mg twice daily), CLN (0.25 mg once daily), the two drugs together at the same doses, or their matched placebos for a 2-week period each. NIF (-13.5% versus placebo) and CLN (-10.2% versus placebo) decreased blood pressure significantly and when combined, blood pressure was further decreased (-17.1% versus placebo). Heart rate was increased by NIF and NIF + CLN but unchanged by CLN alone. Plasma renin activity (PRA) tended to increase with NIF, decreased with CLN (P < 0.05) and was unchanged with NIF + CLN. Plasma aldosterone did not vary during any of the phases of the trial. These results indicate that NIF and CLN do not interact negatively on blood pressure control in essential hypertensive subjects.
钙通道阻滞剂硝苯地平（NIF）急性给药可降低动物体内α-肾上腺素能激动剂可乐定（CLN）的降压效果。为评估在慢性治疗期间NIF和CLN在人体中可能存在的负面相互作用，12例轻度至中度无并发症的原发性高血压患者分别接受NIF（每日两次，每次20mg）、CLN（每日一次，每次0.25mg）、两种药物同剂量联合使用或各自匹配的安慰剂治疗，每种治疗为期2周。NIF（与安慰剂相比降低13.5%）和CLN（与安慰剂相比降低10.2%）均显著降低血压，联合使用时血压进一步降低（与安慰剂相比降低17.1%）。NIF和NIF + CLN使心率增加，而单独使用CLN时心率无变化。血浆肾素活性（PRA）在NIF治疗时呈升高趋势，在CLN治疗时降低（P < 0.05），在NIF + CLN治疗时无变化。在试验的任何阶段，血浆醛固酮均无变化。这些结果表明，在原发性高血压患者中，NIF和CLN在血压控制方面不存在负面相互作用。
