Wiechmann H W
Medizinische Universitätsklinik der Ruhr-Universität Bochum, Marienhospital Herne 1.
Dtsch Med Wochenschr. 1988 Jun 24;113(25):1007-12. doi: 10.1055/s-2008-1067758.
The haemodynamic effects of combinations of antihypertensive drugs were tested in an open trial on 15 patients with essential arterial hypertension. The following combinations were used: Piretanid/Captopril, Piretanid/Urapidil and Acebutolol/Piretanid. All three combinations significantly lowered arterial pressure at rest and on exercise. Both Piretanid/Captopril and Piretanid/Urapidil reduced the arterial pressure exclusively by reduction of the peripheral resistance, while cardiac output rose. On the other hand, Acebutolol/Piretanid reduced the blood pressure through reduction of cardiac output, less so by lowering the peripheral resistance. Mean pulmonary arterial pressure, as a measure of left-ventricular filling pressure, fell under Piretanid/Captopril and Piretanid/Urapidil, remaining high under Acebutolol/Piretanid. Thus the combinations of Piretanid/Captopril and Piretanid/Urapidil are most likely to fulfill the demands to be placed on an "ideal" antihypertensive treatment.
在一项针对15例原发性动脉高血压患者的开放性试验中，测试了联合使用抗高血压药物的血流动力学效应。使用了以下几种联合用药方案：吡咯他尼/卡托普利、吡咯他尼/乌拉地尔和醋丁洛尔/吡咯他尼。所有三种联合用药方案均能显著降低静息和运动时的动脉血压。吡咯他尼/卡托普利和吡咯他尼/乌拉地尔均仅通过降低外周阻力来降低动脉血压，同时心输出量增加。另一方面，醋丁洛尔/吡咯他尼则通过降低心输出量来降低血压，通过降低外周阻力来降低血压的作用较小。作为左心室充盈压指标的平均肺动脉压，在吡咯他尼/卡托普利和吡咯他尼/乌拉地尔治疗下下降，在醋丁洛尔/吡咯他尼治疗下仍保持较高水平。因此，吡咯他尼/卡托普利和吡咯他尼/乌拉地尔的联合用药方案最有可能满足对“理想”抗高血压治疗的要求。
