Abernethy D R, Bartos P, Plachetka J R
Department of Medicine, Baylor College of Medicine, Houston, Texas.
J Clin Pharmacol. 1987 Nov;27(11):902-6. doi: 10.1002/j.1552-4604.1987.tb05586.x.
The efficacy and safety of labetalol therapy were evaluated in 20 patients 60 years and older with isolated systolic or diastolic hypertension and 19 patients aged younger than 60 years with diastolic hypertension. After a two-week placebo washout period, labetalol was titrated for up to four weeks (100-400 mg bid) until blood pressure control was achieved (standing systolic less than 160 mm Hg or greater than or equal to 10% reduction from baseline, and standing diastolic less than 90 mm Hg or a decrease of 10 mm Hg from baseline). Mean decreases in standing systolic and diastolic blood pressure from baseline were statistically significant for both age groups (greater than or equal to 60 years, -23/-13; less than 60 years, -18/-12, P less than .01). Control criteria were met in 18 (90%) older and 15 (79%) younger patients who then entered a four-week maintenance period. Sixteen (80%) of the older patients and six (32%) of the younger patients maintained blood pressure control on 200 mg or less of labetalol bid (P less than .05). Three patients, two of whom withdrew from the study, were judged to have experienced adverse events that were drug related. It was concluded that labetalol was effective and well-tolerated antihypertensive therapy in both elderly and younger patients. In addition, significantly less medication was required to achieve blood pressure control in the elderly.
对20例60岁及以上的单纯收缩期或舒张期高血压患者以及19例60岁以下的舒张期高血压患者进行了拉贝洛尔治疗的疗效和安全性评估。在为期两周的安慰剂洗脱期后,拉贝洛尔滴定给药长达四周(每日两次,每次100 - 400毫克),直至血压得到控制(站立位收缩压低于160毫米汞柱或较基线水平降低10%及以上,且站立位舒张压低于90毫米汞柱或较基线水平降低10毫米汞柱)。两个年龄组从基线水平算起的站立位收缩压和舒张压的平均降幅均具有统计学意义(60岁及以上,-23 / -13;60岁以下,-18 / -12,P <.01)。18例(90%)老年患者和15例(79%)年轻患者达到了控制标准,随后进入为期四周的维持期。16例(80%)老年患者和6例(32%)年轻患者在每日两次服用200毫克或更低剂量的拉贝洛尔时维持了血压控制(P <.05)。3例患者被判定出现了与药物相关的不良事件,其中2例退出了研究。得出的结论是,拉贝洛尔在老年和年轻患者中都是有效的且耐受性良好的抗高血压治疗药物。此外,老年患者实现血压控制所需的药物剂量显著更少。