Matsukawa S, Suzuki H, Itaya Y, Nakajima S, Saruta T
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
J Clin Hypertens. 1987 Dec;3(4):452-62.
Both the antihypertensive efficacy and side effects of nifedipine were investigated in hypertensive patients with impaired renal function (n = 44) in short-term (7 days) and long-term (6 months) therapeutic trials. Comparable hypotensive effects were obtained in both the short- and long-term studies (from 184 +/- 4.6/108 +/- 2.8 to 166 +/- 4.6/97 +/- 3.2 mmHg, and from 178 +/- 4.2/108 +/- 2.1 to 157 +/- 4.4/95 +/- 2.4 mmHg, respectively). In the short-term study (n = 20), the antihypertensive effect was significantly related to the pretreatment blood pressure (r = 0.51) and inversely related to the plasma renin activity (PRA) (r = -0.61; p less than 0.05). However, it was not related to age or reciprocal value of the pretreatment serum creatinine. In the long-term study (n = 24), blood-pressure-lowering effects of nifedipine were found to depend on the reciprocal value of the serum creatinine but not on PRA. The blood urea nitrogen and creatinine were not changed significantly during the observation period. Side effects occurred in 8 of the 44 patients, but severe side effects necessitating termination of administration were observed in only 2 patients. These results indicate that nifedipine is effective in both the short- and long-term treatment of hypertensives patients with impaired renal function. Impaired renal function is a key factor in the hypotensive effects of nifedipine in long-term therapy.
在短期（7天）和长期（6个月）治疗试验中，对44例肾功能受损的高血压患者研究了硝苯地平的降压疗效和副作用。短期和长期研究均获得了相当的降压效果（分别从184±4.6/108±2.8降至166±4.6/97±3.2 mmHg，以及从178±4.2/108±2.1降至157±4.4/95±2.4 mmHg）。在短期研究（n = 20）中，降压效果与治疗前血压显著相关（r = 0.51），与血浆肾素活性呈负相关（PRA）（r = -0.61；p<0.05）。然而，它与年龄或治疗前血清肌酐的倒数无关。在长期研究（n = 24）中，发现硝苯地平的降压效果取决于血清肌酐的倒数，而不取决于PRA。在观察期内血尿素氮和肌酐无显著变化。44例患者中有8例出现副作用，但仅2例观察到需要终止给药的严重副作用。这些结果表明，硝苯地平对肾功能受损的高血压患者进行短期和长期治疗均有效。肾功能受损是硝苯地平长期治疗中产生降压效果的关键因素。
