Jeunemaitre X, Valenta de Almeida L, Sassano P, Farge D, Guyene T T, Julien J, Plouin P F, Corvol P
Service d'hypertension artérielle, hôpital Broussais, Paris.
Arch Mal Coeur Vaiss. 1988 Jun;81 Spec No:141-4.
Calcium channel blocking agents are considered to be particularly effective in reducing blood pressure (BP) in low renin essential hypertension and in primary aldosteronism. The aim of this study was to compare the acute BP response to nicardipine in 2 opposite situations of stimulation of the renin angiotensin system: eight patients (49 +/- 13 years, mean arterial BP (MAP) 123 +/- 8 mmHg) with primary aldosteronism (active renin less than 5 pg/ml, group 1) and nine patients (38 +/- 17 years, MAP: 107 +/- 13 mmHg) with renovascular hypertension and high level of active renin (greater than 25 pg/ml, group 2). They had not taken any antihypertensive treatment since at least one week. After 60 minutes in the supine position (T0) nicardipine was infused at a rate of 7.5 mg/h during 10 minutes (T10), 15 mg/h from the 10th to 20th minute (T20) and 30 mg/h during the last ten minutes (T30). Thus, a total cumulative dose of 8.75 mg was administrated in 30 minutes. BP was recorded by an indirect oscillometric method (Sentrom) every 2 minutes and renin was assayed through an immuno-radiometric procedure (IRMA). There was an important and similar BP fall in the 2 groups (Gr 1: T10-6 p. 100, T20-17 p. 100, T30-25 p. 100; Gr 2: T10-7 p. 100, T20-13 p. 100, T30-18 p. 100) with a very significant dose-effect relation (r = 0.67, p less than 0.001). There was also an important increase in heart rate similar in the 2 groups (+35 p. 100, +25 p. 100, ns).(ABSTRACT TRUNCATED AT 250 WORDS)
钙通道阻滞剂被认为在降低低肾素性原发性高血压和原发性醛固酮增多症患者的血压方面特别有效。本研究的目的是比较在肾素-血管紧张素系统受刺激的两种相反情况下，尼卡地平对血压的急性反应：8例原发性醛固酮增多症患者（49±13岁，平均动脉压（MAP）123±8 mmHg，活性肾素低于5 pg/ml，第1组）和9例肾血管性高血压且活性肾素水平高（大于25 pg/ml，第2组）患者（38±17岁，MAP：107±13 mmHg）。他们至少一周未服用任何降压治疗。仰卧位60分钟后（T0），在10分钟内以7.5 mg/h的速率输注尼卡地平（T10），从第10至20分钟以15 mg/h输注（T20），最后10分钟以30 mg/h输注（T30）。因此，30分钟内共给予累积剂量8.75 mg。每2分钟通过间接示波法（Sentrom）记录血压，并通过免疫放射测定法（IRMA）测定肾素。两组血压均有显著且相似的下降（第1组：T10时下降6%，T20时下降17%，T30时下降25%；第2组：T10时下降7%，T20时下降13%，T30时下降18%），存在非常显著的剂量-效应关系（r = 0.67，p＜0.001）。两组心率也有显著增加且相似（分别增加35%、25%，无显著差异）。（摘要截短至250字）
