Gavras I, Mulinari R, Gavras H, Higgins J T, Reeves R L, Zawada E T, Crook J, Halperin A K, Garrett B
Department of Medicine, Boston City Hospital, Massachusetts.
Am J Med. 1987 Dec 21;83(6B):20-3. doi: 10.1016/0002-9343(87)90632-2.
The results of a multicenter trial conducted in order to determine the therapeutic efficacy of the gastrointestinal therapeutic system (GITS) formulation of nifedipine in comparison with hydrochlorothiazide and placebo in the management of mild to moderate essential hypertension are presented. During a one-week wash-out phase, antihypertensive therapy was discontinued in all patients. After a three-week single-blind placebo period, eligible patients were randomly assigned in a double-blind fashion to one of three treatment groups for a one-week titration period and a nine-week efficacy period. Patients received either nifedipine GITS, 30 or 60 mg daily; hydrochlorothiazide, 25 or 50 mg daily; or placebo. Sitting and standing blood pressures decreased by an average 11.6/10.4 and 10.8/10.8 mm Hg, respectively, with nifedipine GITS therapy, and 14.8/10.8 and 14.3/8.2 mm Hg, respectively, with hydrochlorothiazide therapy. Compared with placebo, these changes were highly significant for both sitting (p less than or equal to 0.005) and standing (p less than or equal to 0.02) measurements. Heart rate remained essentially unchanged in all three groups. It was therefore concluded that monotherapy with nifedipine GITS, at doses of 30 or 60 mg given once daily, effectively reduces blood pressure in patients with hypertension to a degree comparable with that seen in hydrochlorothiazide therapy.
本文展示了一项多中心试验的结果,该试验旨在确定硝苯地平胃肠道治疗系统(GITS)制剂与氢氯噻嗪及安慰剂相比,在治疗轻至中度原发性高血压中的疗效。在为期一周的洗脱期内,所有患者均停止抗高血压治疗。经过为期三周的单盲安慰剂期后,符合条件的患者以双盲方式随机分配至三个治疗组之一,进行为期一周的滴定期和为期九周的疗效期。患者分别接受每日30或60毫克的硝苯地平GITS、每日25或50毫克的氢氯噻嗪或安慰剂治疗。硝苯地平GITS治疗组患者的坐位和立位血压平均分别下降11.6/10.4和10.8/10.8毫米汞柱,氢氯噻嗪治疗组患者的坐位和立位血压平均分别下降14.8/10.8和14.3/8.2毫米汞柱。与安慰剂相比,这些变化在坐位(p≤0.005)和立位(p≤0.02)测量中均具有高度显著性。三组患者的心率基本保持不变。因此得出结论,每日一次给予30或60毫克剂量的硝苯地平GITS单药治疗可有效降低高血压患者的血压,其降低程度与氢氯噻嗪治疗相当。