Frishman W, Charlap S, Kimmel B, Saltzberg S, Stroh J, Weinberg P, Monuszko E, Wiezner J, Dorsa F, Pollack S
Arch Intern Med. 1986 Mar;146(3):561-5.
The antihypertensive effect of twice-daily administration of verapamil hydrochloride was evaluated in 21 adult patients with mild to moderate essential hypertension. Following four weeks of placebo therapy, verapamil was given for four weeks with a treatment goal of sitting diastolic blood pressure (BP) of less than 90 mm Hg, or to a maximum dose of 160 mg twice daily. Sitting and standing BPs, heart rate, and verapamil plasma levels were determined weekly, ten to 12 hours post dose. At the maximal dose (mean, 154 +/- 19.2 mg), heart rate was not affected, side effects were minimal, and sitting diastolic BP was significantly reduced from placebo baseline, with 12 of 21 patients having a fall in sitting diastolic BP of 10 mm Hg or more or less than 90 mm Hg. A trough verapamil plasma level of greater than 80 ng/mL was associated with a good hypotensive response. These data indicate the safety and utility of twice-daily verapamil administration for the treatment of essential hypertension and suggest the value of obtaining verapamil plasma levels as a guide to dosage determination.
对21例轻至中度原发性高血压成年患者评估了每日两次服用盐酸维拉帕米的降压效果。在四周的安慰剂治疗后，给予维拉帕米治疗四周，治疗目标为坐位舒张压（BP）低于90 mmHg，或最大剂量为每日两次160 mg。每周在给药后10至12小时测定坐位和立位血压、心率以及维拉帕米血浆水平。在最大剂量（平均，154±19.2 mg）时，心率未受影响，副作用轻微，坐位舒张压较安慰剂基线显著降低，21例患者中有12例坐位舒张压下降10 mmHg或更多或低于90 mmHg。维拉帕米血浆谷浓度大于80 ng/mL与良好的降压反应相关。这些数据表明每日两次服用维拉帕米治疗原发性高血压的安全性和有效性，并提示测定维拉帕米血浆水平对确定剂量的价值。
