Bruun N E, Ibsen H, Nielsen F, Nielsen M D, Moelbak A G, Hartling O J
Hypertension. 1986 Aug;8(8):655-61. doi: 10.1161/01.hyp.8.8.655.
The influence of long-term nifedipine treatment on body fluid compartments, renal function, the renin-angiotensin system, and the adrenergic system was studied in 18 patients with essential hypertension. A placebo period of 4 weeks was followed by a 6-week dose-titration period. Thereafter, the dose was kept constant for an additional 6 weeks (mean dose, 51 mg/day). As compared with placebo values, diastolic blood pressure decreased approximately 12% during nifedipine treatment. Plasma volume, extracellular fluid volume, and the ratio of plasma to interstitial fluid volume did not change significantly, either in the group as a whole or in a subgroup in which pedal edema developed. Plasma concentrations of epinephrine and norepinephrine increased slightly after 2 weeks of treatment, but they returned to control values after 6 weeks of therapy. Plasma concentrations of renin, angiotensin II, and aldosterone did not change significantly. Glomerular filtration rate and renal clearances of sodium and potassium were unchanged as well. These results indicate that long-term nifedipine treatment does not lead to activation of counterregulatory mechanisms, such as fluid retention or the renin-angiotensin or adrenergic systems. This may well be of importance for the antihypertensive efficacy of nifedipine treatment.
在18例原发性高血压患者中研究了长期硝苯地平治疗对体液分布、肾功能、肾素-血管紧张素系统和肾上腺素能系统的影响。4周的安慰剂期之后是6周的剂量滴定期。此后，剂量再维持6周不变（平均剂量，51毫克/天）。与安慰剂值相比，硝苯地平治疗期间舒张压降低约12%。总体组以及出现足部水肿的亚组中，血浆容量、细胞外液容量以及血浆与组织间液容量之比均无显著变化。治疗2周后肾上腺素和去甲肾上腺素的血浆浓度略有升高，但治疗6周后恢复至对照值。肾素、血管紧张素II和醛固酮的血浆浓度无显著变化。肾小球滤过率以及钠和钾的肾清除率也未改变。这些结果表明，长期硝苯地平治疗不会导致诸如液体潴留或肾素-血管紧张素或肾上腺素能系统等反调节机制的激活。这对于硝苯地平治疗的降压疗效可能很重要。
