MacGregor G A, Pevahouse J B, Cappuccio F P, Markandu N D
Department of Medicine, Charing Cross and Westminster Medical School, London, UK.
J Hypertens Suppl. 1987 Dec;5(4):S127-31. doi: 10.1097/00004872-198712004-00021.
There is controversy about the antihypertensive effect of thiazide diuretics in patients already being treated with nifedipine. Studies that we have conducted suggest that the antihypertensive effect of the thiazide may be blunted in the presence of nifedipine. One possible explanation for this blunted response is that nifedipine has a long-term effect on sodium balance. In a study where long-term nifedipine was withdrawn from hypertensive patients there was evidence that withdrawal of nifedipine was accompanied by sodium retention, as judged by changes in urinary sodium excretion. If these results are confirmed in larger studies, they have important therapeutic implications for the use of nifedipine.
对于已经正在服用硝苯地平的患者，噻嗪类利尿剂的降压效果存在争议。我们所进行的研究表明，在硝苯地平存在的情况下，噻嗪类利尿剂的降压效果可能会减弱。这种减弱反应的一种可能解释是硝苯地平对钠平衡有长期影响。在一项研究中，从高血压患者中撤掉长期使用的硝苯地平后，有证据表明，根据尿钠排泄的变化判断，撤掉硝苯地平会伴有钠潴留。如果这些结果在更大规模的研究中得到证实，它们对于硝苯地平的使用具有重要的治疗意义。
