Erne P, Bolli P, Bertel O, Hulthen U L, Kiowski W, Muller F B, Buhler F
Hypertension. 1983 Jul-Aug;5(4 Pt 2):II97-102. doi: 10.1161/01.hyp.5.4_pt_2.ii97.
The antihypertensive efficacy of monotherapy with the calcium antagonists nifedipine (n = 60) and verapamil (n = 43) was investigated in patients with essential hypertension. Relationships between age, pretreatment blood pressure, pretreatment plasma renin activity, and hypotensive response were examined. Intraindividual differences in the responses to both drugs were also studied (n = 16). Treatment with verapamil had to be discontinued because of constipation in one patient; treatment with nifedipine was discontinued because of headache in 11 and ankle edema in one. The antihypertensive efficacy of nifedipine and verapamil was comparable and was positively related to pretreatment mean blood pressure (p less than 0.001) and inversely to pretreatment plasma renin activity (p less than 0.05). With verapamil, the fall in blood pressure correlated positively with the patient's age (p less than 0.001). Thus, calcium antagonists can be used as first-line drugs, especially in older and low renin patients. The relationship between the antihypertensive response and pretreatment blood pressure suggests that there may be a calcium influx-dependent vasoconstrictor mechanism in essential hypertension which may be more pronounced in patients with low plasma renin.
在原发性高血压患者中，研究了钙拮抗剂硝苯地平（n = 60）和维拉帕米（n = 43）单药治疗的降压疗效。研究了年龄、治疗前血压、治疗前血浆肾素活性与降压反应之间的关系。还研究了16例患者对两种药物反应的个体内差异。1例患者因便秘而不得不停止维拉帕米治疗；11例患者因头痛、1例患者因踝部水肿而停止硝苯地平治疗。硝苯地平和维拉帕米的降压疗效相当，且与治疗前平均血压呈正相关（p < 0.001），与治疗前血浆肾素活性呈负相关（p < 0.05）。使用维拉帕米时，血压下降与患者年龄呈正相关（p < 0.001）。因此，钙拮抗剂可用作一线药物，尤其是在老年和低肾素患者中。降压反应与治疗前血压之间的关系表明，原发性高血压中可能存在钙内流依赖性血管收缩机制，这在血浆肾素水平低的患者中可能更明显。
