Fontanet H, García J C, del Río J, Martínez-Maldonado M
Arch Intern Med. 1987 Mar;147(3):426-8.
Isosorbide dinitrate was administered sublingually and compared with placebo in a double-blind, randomized fashion to determine its effectiveness and safety in the rapid control of severe arterial hypertension. In 11 patients who received 10 mg of isosorbide dinitrate, blood pressure (BP) dropped from 205 +/- 8/131 +/- 3 to 166 +/- 9/106 +/- 5 mm Hg at 120 minutes. In eight patients who received placebo, BP dropped from 203 +/- 8/130 +/- 3 to 193 +/- 11/122 +/- 5 mm Hg at 120 minutes. When 10 mg of isosorbide dinitrate was administered sublingually after 120 minutes to placebo-pretreated patients, their BP dropped to 161 +/- 7/105 +/- 6 mm Hg at 240 minutes. Our study group (19 patients) was compared with a "control" group (six patients) whose BP (203 +/- 12/132 +/- 8 mm Hg) was treated only with conventional antihypertensive medications and bed rest; five (83%) of the six controls achieved steady BP control at 24 hours vs nine (47%) of the 19 study patients pretreated with isosorbide. There were no side effects, including hypotension, orthostatic effect, and reflex tachycardia. Sublingual isosorbide safely and effectively lowers systolic and diastolic BP in patients with severe, uncontrolled arterial hypertension.
采用双盲、随机方式将硝酸异山梨酯舌下给药，并与安慰剂进行比较，以确定其在快速控制重度动脉高血压方面的有效性和安全性。11例接受10mg硝酸异山梨酯的患者，120分钟时血压（BP）从205±8/131±3降至166±9/106±5mmHg。8例接受安慰剂的患者，120分钟时血压从203±8/130±3降至193±11/122±5mmHg。在120分钟后对接受安慰剂预处理的患者舌下给予10mg硝酸异山梨酯，240分钟时他们的血压降至161±7/105±6mmHg。将我们的研究组（19例患者）与“对照组”（6例患者）进行比较，“对照组”仅采用传统抗高血压药物和卧床休息治疗，血压为203±12/132±8mmHg；6例对照组中有5例（83%）在24小时时实现了血压稳定控制，而19例接受硝酸异山梨酯预处理的研究患者中有9例（47%）实现了血压稳定控制。未出现包括低血压、体位性效应和反射性心动过速在内的副作用。舌下含服硝酸异山梨酯可安全有效地降低重度、未控制的动脉高血压患者的收缩压和舒张压。
