Wiechmann H W
Medizinische Universitätsklinik, Ruhr-Universität Bochum, Marienhospital Herne 1.
Dtsch Med Wochenschr. 1987 Oct 9;112(41):1566-71. doi: 10.1055/s-2008-1068292.
The haemodynamic effects of piretanide, acebutolol and nifedipine were tested and compared at rest and on exercise in an open study of patients with essential hypertension, grade II (WHO). All three drugs lowered the blood pressure significantly, both at rest and on exercise. There was no significant difference between the three drugs in their effect on resting blood pressure, but nifedipine and acebutolol were significantly more effective than piretanide in lowering it on exercise. Piretanide lowered the blood pressure by reduction in cardiac output and peripheral resistance, nifedipine entirely through a reduction of peripheral resistance, and acebutolol entirely through a reduction in cardiac output. Mean pulmonary arterial pressure, taken as a measure of left-ventricular filling pressure, was significantly reduced by piretanide and nifedipine, while it rose significantly under acebutolol. Taking into account the haemodynamics of essential hypertension (raised peripheral resistance, decreased cardiac output, frequently increased left-ventricular filling pressure), nifedipine most nearly fulfilled the role of an "ideal" antihypertensive agent.
在一项针对II级（WHO标准）原发性高血压患者的开放性研究中，对吡咯他尼、醋丁洛尔和硝苯地平在静息及运动状态下的血流动力学效应进行了测试和比较。所有三种药物在静息和运动时均能显著降低血压。三种药物对静息血压的影响无显著差异，但硝苯地平和醋丁洛尔在运动时降压效果显著优于吡咯他尼。吡咯他尼通过降低心输出量和外周阻力来降低血压，硝苯地平完全通过降低外周阻力来降压，而醋丁洛尔完全通过降低心输出量来降压。作为左心室充盈压指标的平均肺动脉压，吡咯他尼和硝苯地平可使其显著降低，而在醋丁洛尔作用下则显著升高。考虑到原发性高血压的血流动力学特点（外周阻力升高、心输出量降低、左心室充盈压常升高），硝苯地平最接近“理想”抗高血压药物的作用。
