Jansen R W, Van Lier H J, Hoefnagels W H
Department of Medicine, University Hospital Nijmegen, The Netherlands.
Clin Pharmacol Ther. 1989 Mar;45(3):291-8. doi: 10.1038/clpt.1989.31.
The effects of nitrendipine and hydrochlorothiazide were studied in hypertensive elderly patients. Blood pressure was reduced (p less than 0.01) by both nitrendipine (13/10 +/- 4/3 mm Hg [n = 15], mean +/- SE) and hydrochlorothiazide (25/11 +/- 4/2 mm Hg [n = 16]). After hydrochlorothiazide, plasma glucose, uric acid, and renin activity increased and plasma potassium levels decreased. Edema and flushing were the main adverse reactions during nitrendipine. The response of blood pressure and heart rate to head-up tilt were not significantly different under both treatments. However, the effects of both drugs on diastolic blood pressure and norepinephrine responses to head-up tilt differed significantly. We conclude that, in the elderly, hydrochlorothiazide lowers systolic blood pressure more effectively than nitrendipine. However, nitrendipine does not have any of the potentially harmful metabolic side effects that were found during hydrochlorothiazide therapy. The clinical significance of a lower vasoreactivity during nitrendipine, as was found with the head-up tilt test, has to be established.
在老年高血压患者中研究了尼群地平和氢氯噻嗪的疗效。尼群地平（13/10±4/3 mmHg [n = 15]，均值±标准误）和氢氯噻嗪（25/11±4/2 mmHg [n = 16]）均可降低血压（p<0.01）。服用氢氯噻嗪后，血浆葡萄糖、尿酸和肾素活性升高，血浆钾水平降低。水肿和潮红是尼群地平治疗期间的主要不良反应。两种治疗下血压和心率对直立倾斜试验的反应无显著差异。然而，两种药物对舒张压以及去甲肾上腺素对直立倾斜试验的反应存在显著差异。我们得出结论，在老年人中，氢氯噻嗪降低收缩压比尼群地平更有效。然而，尼群地平没有氢氯噻嗪治疗期间发现的任何潜在有害的代谢副作用。如直立倾斜试验所示，尼群地平治疗期间血管反应性降低的临床意义有待确定。
