MacGregor G A, Pevahouse J B, Cappuccio F P, Markandu N D
Department of Medicine, Charing Cross and Westminster Medical School, London, UK.
Am J Nephrol. 1987;7 Suppl 1:44-8. doi: 10.1159/000167542.
The acute blood pressure-lowering effect of nifedipine was studied in patients on high, normal, and low sodium diets. The demonstrated decrease in blood pressure was greatest in those patients receiving the high sodium diet. Studies were then performed with a combination of nifedipine and the diuretic bendrofluazide. When nifedipine was given to patients already on bendrofluazide, there was an additional fall in blood pressure. However, when bendrofluazide was added to the regimen of patients already receiving nifedipine, there was no further reduction in blood pressure. Studies were then performed in patients receiving chronic nifedipine therapy who had their nifedipine treatment stopped while on a fixed sodium intake. All patients retained sodium and there was an increase in weight. This latter study confirms that nifedipine causes a long-term reduction in sodium balance in patients with essential hypertension. It is possible that these long-term changes in sodium balance with nifedipine could partially explain the blunting of the blood pressure-lowering effect seen when the thiazide diuretic was added to the regimen of patients already receiving nifedipine.
在高钠、正常钠和低钠饮食的患者中研究了硝苯地平的急性降压作用。结果表明，接受高钠饮食的患者血压下降幅度最大。随后进行了硝苯地平和利尿剂苄氟噻嗪联合使用的研究。当给已经服用苄氟噻嗪的患者服用硝苯地平时，血压进一步下降。然而，当在已经接受硝苯地平治疗的患者治疗方案中加入苄氟噻嗪时，血压没有进一步降低。然后对接受慢性硝苯地平治疗的患者进行研究，这些患者在固定钠摄入量的情况下停止服用硝苯地平治疗。所有患者都潴留了钠，体重增加。后一项研究证实，硝苯地平可使原发性高血压患者的钠平衡长期降低。硝苯地平引起的钠平衡的这些长期变化可能部分解释了在已经接受硝苯地平治疗的患者治疗方案中加入噻嗪类利尿剂时所观察到的降压效果减弱的现象。
