Muiesan G, Agabiti-Rosei E, Castellano M, Alicandri C L, Corea L, Fariello R, Beschi M, Romanelli G
J Cardiovasc Pharmacol. 1982;4 Suppl 3:S325-9.
The aim of this study was to investigate and compare the effects of two calcium antagonist drugs, verapamil (VER) and nifedipine (NIF), on blood pressure (BP), heart rate (HR), plasma catecholamines (pCA), renin (PRA), plasma aldosterone (pALD), and plasma volume (PV) in a group of patients with mild to moderate essential hypertension. In 12 hypertensive patients on a fixed normal sodium and potassium intake, VER (80 mg t.i.d., per os) first and then NIF (10 mg, t.i.d. per os), or vice versa according to a random sequence, were each given for 8 days, with an interval of 5 days between the two treatments. Both NIF and VER significantly reduced BP (p less than 0.001); this reduction was quantitatively similar in both treatment schedules. Supine and standing PRA, pALD, and PV were not significantly affected by VER or NIF. HR and pCA were unchanged after VER, whereas they were significantly increased (p less than 0.05, at least) mainly in standing position after NIF treatment. The antihypertensive and metabolic effects of VER (80 mg t.i.d.) and NIF (10 mg t.i.d.) were maintained after chronic treatment (4 months with VER in 10 patients and 2 months with NIF in 12 patients). After 2 months of treatment with VER (160 mg t.i.d.) in 18 patients, BP was further reduced, while pCA were slightly increased. In conclusion, VER and NIF are effective and equipotent antihypertensive agents that do not induce significant renin stimulation or fluid retention; adrenergic stimulation seems to be greater with NIF, which should be taken into account in the clinical use of these drugs.
本研究旨在调查和比较两种钙拮抗剂药物维拉帕米（VER）和硝苯地平（NIF）对一组轻度至中度原发性高血压患者的血压（BP）、心率（HR）、血浆儿茶酚胺（pCA）、肾素（PRA）、血浆醛固酮（pALD）和血浆容量（PV）的影响。在12名固定摄入正常钠和钾的高血压患者中，按照随机顺序，先给予VER（80毫克，每日三次，口服），然后给予NIF（10毫克，每日三次，口服），或者反之，每种药物均给予8天，两种治疗之间间隔5天。NIF和VER均显著降低了血压（p<0.001）；两种治疗方案在降低血压的量上相似。VER或NIF对仰卧位和站立位的PRA、pALD和PV均无显著影响。VER治疗后HR和pCA未改变，而NIF治疗后，HR和pCA显著升高（至少p<0.05），主要是在站立位时。慢性治疗后（10名患者用VER治疗4个月，12名患者用NIF治疗2个月），VER（80毫克，每日三次）和NIF（10毫克，每日三次）的降压和代谢作用得以维持。18名患者用VER（160毫克，每日三次）治疗2个月后，血压进一步降低，而pCA略有升高。总之，VER和NIF是有效的等效降压药物，不会引起显著的肾素刺激或液体潴留；NIF的肾上腺素能刺激作用似乎更强，在这些药物的临床应用中应予以考虑。
