Gulizia M, Valenti R, Platania F, D'Onofrio V, Rizzini P, Circo A
Cardiology and Hypertension Centre, S. Curro and S. Luigi G. Hospital, Catania, Italy.
J Cardiovasc Pharmacol. 1994;23 Suppl 5:S101-4. doi: 10.1097/00005344-199423005-00022.
Arterial hypertension is a chronic condition regarded as one of the main risk factors for development of coronary atherosclerosis. As dyslipidemia and reduced glucose tolerance are also risk factors for coronary disease, it is considered important to use antihypertensive drugs having no negative effects on lipid and glucose metabolism when diabetic patients are treated for hypertension. Lacidipine, a new dihydropyridine-like calcium antagonist, has been shown in in vivo and in vitro preclinical studies to possess potent, long-lasting antihypertensive activity. The present study compared the efficacy and safety of once-daily treatment with lacidipine versus nifedipine SR given twice-daily in non-insulin-dependent diabetic patients. Results have shown a similar efficacy of the two treatments: 6 months later, both drugs had reduced blood pressure values [lacidipine from 184.8/105.2 mm Hg to 144.4/87.1 mm Hg; nifedipine slow-release (SR) from 182.3/106.8 mm Hg to 143.6/89.4 mmHg]. However, lacidipine exhibited a lower incidence of adverse events (particularly ankle edema and tachycardia) than nifedipine SR. Finally, both treatments showed no negative effect on metabolic parameters (total cholesterol, high-density lipoprotein cholesterol, triglycerides, and blood glucose).
动脉高血压是一种慢性疾病，被视为冠状动脉粥样硬化发展的主要危险因素之一。由于血脂异常和糖耐量降低也是冠心病的危险因素，因此在糖尿病患者治疗高血压时，使用对脂质和葡萄糖代谢无负面影响的抗高血压药物被认为很重要。拉西地平是一种新型的二氢吡啶类钙拮抗剂，体内和体外临床前研究表明它具有强效、持久的抗高血压活性。本研究比较了非胰岛素依赖型糖尿病患者每日一次服用拉西地平与每日两次服用硝苯地平缓释片的疗效和安全性。结果显示两种治疗方法疗效相似：6个月后，两种药物均降低了血压值[拉西地平从184.8/105.2毫米汞柱降至144.4/87.1毫米汞柱；硝苯地平缓释片从182.3/106.8毫米汞柱降至143.6/89.4毫米汞柱]。然而，拉西地平的不良事件发生率（尤其是脚踝水肿和心动过速）低于硝苯地平缓释片。最后，两种治疗方法对代谢参数（总胆固醇、高密度脂蛋白胆固醇、甘油三酯和血糖）均无负面影响。
