Agabiti-Rosei E, Muiesan M L, Romanelli G, Castellano M, Beschi M, Corea L, Muiesan G
J Am Coll Cardiol. 1986 Apr;7(4):916-24. doi: 10.1016/s0735-1097(86)80357-6.
The short- and long-term effects of two calcium channel blocking drugs, verapamil and nifedipine, on blood pressure, heart rate, plasma catecholamines, plasma renin activity, plasma volume and cardiac performance (echocardiography) were studied in essential hypertensive patients and in normal subjects. Verapamil, 160 mg orally, reduced blood pressure within 60 minutes in 22 hypertensive patients, but not in 12 normotensive subjects. Nifedipine, 10 mg sublingually, reduced blood pressure within 15 minutes in 19 hypertensive patients, but not in 7 normotensive subjects. Plasma noradrenaline was significantly increased both in normal subjects and in hypertensive patients only after nifedipine was administered. Verapamil (80 mg three times a day) first, and nifedipine (10 mg three times a day) thereafter, or vice versa, were given to 12 hospitalized hypertensive patients on a fixed sodium and potassium intake; the drugs produced similar blood pressure reductions, but heart rate and plasma catecholamines were increased only after nifedipine (p less than 0.05). Neither drug affected plasma volume, aldosterone or plasma renin activity. Long-term ambulatory treatment with verapamil (80 or 160 mg three times a day for 2 to 4 months) or nifedipine (10 mg three times a day for 2 months) produced changes in all variables that were similar to those observed in the hospital (controlled) study. Shortening fraction was significantly increased after nifedipine (p less than 0.05) but no change was observed after verapamil. In conclusion, blood pressure is effectively reduced by both verapamil and nifedipine; an appreciable adrenergic stimulation may be caused by nifedipine, but usually not by verapamil, and fluid retention, renin release or myocardial depression is not observed during verapamil or nifedipine treatment.
在原发性高血压患者和正常受试者中，研究了两种钙通道阻滞剂维拉帕米和硝苯地平对血压、心率、血浆儿茶酚胺、血浆肾素活性、血浆容量和心脏功能（超声心动图）的短期和长期影响。口服160毫克维拉帕米可使22例高血压患者在60分钟内血压降低，但对12例血压正常的受试者无效。舌下含服10毫克硝苯地平可使19例高血压患者在15分钟内血压降低，但对7例血压正常的受试者无效。仅在服用硝苯地平后，正常受试者和高血压患者的血浆去甲肾上腺素均显著升高。12例住院高血压患者在固定钠和钾摄入量的情况下，先给予维拉帕米（80毫克，每日三次），然后给予硝苯地平（10毫克，每日三次），或反之；两种药物降低血压的效果相似，但仅在服用硝苯地平后心率和血浆儿茶酚胺升高（p<0.05）。两种药物均不影响血浆容量、醛固酮或血浆肾素活性。维拉帕米（80或160毫克，每日三次，持续2至4个月）或硝苯地平（10毫克，每日三次，持续2个月）的长期门诊治疗使所有变量发生的变化与住院（对照）研究中观察到的相似。硝苯地平治疗后缩短分数显著增加（p<0.05），但维拉帕米治疗后未观察到变化。总之，维拉帕米和硝苯地平均可有效降低血压；硝苯地平可能引起明显的肾上腺素能刺激，但维拉帕米通常不会，并且在维拉帕米或硝苯地平治疗期间未观察到液体潴留、肾素释放或心肌抑制。
