Koffer H, Vlasses P H, Ferguson R K, Weis M, Adler A G
JAMA. 1980 Dec 5;244(22):2532-5.
Eight hypertensive patients with normal renal function and receiving diuretic therapy for at least 28 days received captopril in small increasing doses (6.25, 12.5, and 25 mg). Supine and standing blood pressure (BP) and pulse rate, plasma renin activity (PRA), and plasma aldosterone concentration (PAC) were measured before and after captopril administration. The mean (+/- SEM) maximal decline in BP was 38/18 +/- 3/2, 34/18 +/- 4/2, and 25/17 +/- 3/2 mm Hg and occurred within 70 minutes of each of the three doses. In contrast, the duration of a 10 mm Hg or greater decrease in BP was prolonged markedly (103 +/- 5, 175 +/- 15, and 287 +/- 10 minutes) after each dose increment. After captopril, mean PRA levels increased while PAC levels fell. Transient dizziness on standing occurred in two patients, but captopril was otherwise well tolerated. Evaluation of the response to initial doses of captopril appears to be helpful in predicting maintenance requirements.
八名肾功能正常且接受利尿治疗至少28天的高血压患者，接受小剂量递增的卡托普利治疗（6.25毫克、12.5毫克和25毫克）。在服用卡托普利前后测量仰卧位和站立位血压（BP）、脉搏率、血浆肾素活性（PRA）和血浆醛固酮浓度（PAC）。血压的平均（±标准误）最大降幅分别为38/18±3/2、34/18±4/2和25/17±3/2毫米汞柱，且在三种剂量中的每种剂量给药后70分钟内出现。相比之下，每次剂量增加后，血压下降10毫米汞柱或更多的持续时间显著延长（分别为103±5、175±15和287±10分钟）。服用卡托普利后，平均PRA水平升高而PAC水平下降。两名患者站立时出现短暂头晕，但卡托普利在其他方面耐受性良好。评估对卡托普利初始剂量的反应似乎有助于预测维持治疗的需求。
