Yagil Y, Leibel B, Kobrin I, Stessman J, Ishay D B
Postgrad Med J. 1983;59 Suppl 2:114-8.
The long term efficacy and tolerability of nifedipine combined with propranolol was assessed in a group of hypertensive patients inadequately controlled on propranolol alone. Twenty-six subjects were initially treated with propranolol in a constant daily dose of 160-240 mg, for up to 4 weeks. Nifedipine, 30 mg/day, was added and the dose was titrated upwards to 90 mg/day to achieve normal blood pressure. In 22 patients receiving the combined therapy for 14-30 weeks, mean arterial pressure dropped from 138 +/- 3 mmHg to 102 +/- 2 mmHg. Thirteen patients experienced untoward effects, and 4 discontinued the study. In the remaining 9, side effects were mild and well tolerated. Seventeen patients were subsequently treated sequentially with propranolol alone, combined therapy and nifedipine alone, to assess the efficacy of each regimen and the additive effect of each drug. The combined regimen was found to be more effective than either drug alone. A subgroup continued either combined therapy (14) or nifedipine monotherapy (3) and was followed for up to 9 months. Blood pressure control was maintained in the majority, but 4 more patients dropped out because of side effects. We conclude that the long term use of nifedipine combined with propranolol is effective and relatively well tolerated, and may offer an alternative approach to the treatment of moderately severe hypertension.
在一组单独使用普萘洛尔血压控制不佳的高血压患者中，评估了硝苯地平联合普萘洛尔的长期疗效和耐受性。26名受试者最初接受每日160 - 240毫克恒定剂量的普萘洛尔治疗，长达4周。添加30毫克/天的硝苯地平，并将剂量逐步增加至90毫克/天以实现血压正常。在22名接受联合治疗14 - 30周的患者中，平均动脉压从138±3毫米汞柱降至102±2毫米汞柱。13名患者出现不良反应，4名患者停止研究。在其余9名患者中，副作用轻微且耐受性良好。随后，17名患者依次接受单独使用普萘洛尔、联合治疗和单独使用硝苯地平治疗，以评估每种治疗方案的疗效和每种药物的附加效果。发现联合治疗方案比单独使用任何一种药物都更有效。一个亚组继续联合治疗（14名）或硝苯地平单药治疗（3名），并随访长达9个月。大多数患者的血压得到控制，但又有4名患者因副作用退出。我们得出结论，长期使用硝苯地平联合普萘洛尔是有效的，且耐受性相对良好，可能为中度严重高血压的治疗提供一种替代方法。
