Marone C, Luisoli S, Bomio F, Beretta-Piccoli C, Bianchetti M G, Weidmann P
J Hypertens Suppl. 1984 Dec;2(3):S449-52.
Exchangeable sodium, blood volume, plasma norepinephrine, epinephrine, renin levels, and pressor responses to infused norepinephrine or angiotensin II were assessed in 10 patients with essential hypertension on placebo, following six to eight weeks of monotherapy with nifedipine, 3 X 10-20 mg/day, and after six to eight weeks on nifedipine combined with the diuretic chlorthalidone, 25 to 50 mg/day. Supine blood pressure was decreased after nifedipine alone (P less than 0.05) and even further after nifedipine + chlorthalidone (P less than 0.01). Body weight and exchangeable sodium increased after nifedipine (P less than 0.05), but were decreased after adding chlorthalidone. Blood volume was unchanged after nifedipine, but was reduced on nifedipine + chlorthalidone (P less than 0.05). Heart rate, supine plasma renin, catecholamine levels, and pressor responses to norepinephrine or angiotensin II were not consistently changed on nifedipine alone or combined with chlorthalidone. These findings indicate that in the established phase of treatment, nifedipine may exert its antihypertensive effect without necessarily altering cardiovascular responsiveness to norepinephrine and angiotensin II. Moreover, mild sodium retention may develop on nifedipine at least in some hypertensive patients.
在10例原发性高血压患者中，分别于服用安慰剂时、硝苯地平（3×10 - 20毫克/天）单药治疗6至8周后以及硝苯地平（3×10 - 20毫克/天）联合利尿剂氢氯噻嗪（25至50毫克/天）治疗6至8周后，评估了可交换钠、血容量、血浆去甲肾上腺素、肾上腺素、肾素水平以及对输注去甲肾上腺素或血管紧张素II的升压反应。单独使用硝苯地平后仰卧位血压下降（P<0.05），硝苯地平 + 氢氯噻嗪联合使用后血压进一步下降（P<0.01）。硝苯地平治疗后体重和可交换钠增加（P<0.05），但加用氢氯噻嗪后体重和可交换钠下降。硝苯地平治疗后血容量未改变，但硝苯地平 + 氢氯噻嗪联合使用后血容量减少（P<0.05）。单独使用硝苯地平或联合氢氯噻嗪时，心率、仰卧位血浆肾素、儿茶酚胺水平以及对去甲肾上腺素或血管紧张素II的升压反应并非持续改变。这些发现表明，在治疗的稳定阶段，硝苯地平可能发挥其降压作用而不一定改变心血管系统对去甲肾上腺素和血管紧张素II的反应性。此外，至少在一些高血压患者中，硝苯地平治疗可能会出现轻度钠潴留。
