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硝苯地平在老年原发性高血压患者中的应用:治疗的患者依从性、安全性及疗效

[Use of nifedipine in elderly patients with essential hypertension: patient compliance, safety and efficacy of therapy].

作者信息

Kawecka-Jaszcz K, Kocemba J, Czarnecka D, Grodzicki T, Gryglewska B

机构信息

I Kliniki Kardiologii IK AM, Krakowie.

出版信息

Pol Tyg Lek. 1994;49(10-11):231-4.

PMID:7862585
Abstract

The aim of the study was to evaluate chronic treatment with Cordafen (nifedipine) in the out-patients over 60 years of age with established arterial hypertension. Out of 100 out-patients aged 60-83 years 69 subjects completed one-year study. The main reasons of drop-outs were: lack of patient compliance (12%), severe side effects (11%), ineffective monotherapy (5%) and other (3%). Less severe adverse effects were found in further 20 subjects. After one-year therapy hematological and biochemical parameters of the homeostasis did not deteriorate except an increase in alkaline phosphatase. Regular drug intake in a dose of 20-80 mg/daily (mean = 46.0) produced a significant decrease in the blood pressure level and an improvement of cardiac function indices (CO nad EF). In contrast Cordafen did not reduce the differences between extreme blood pressure values recorded automatically, and it did not produce a significant regression of left ventricular mass and cardiac arrhythmias. Nifedipine in mild or moderate hypertension in the elderly patient any be an adequate form of monotherapy in about 70% of them. Higher motivation for treatment in this age group and better drug tolerance may further improve this efficacy.

摘要

本研究的目的是评估用科达芬(硝苯地平)对60岁以上确诊为动脉高血压的门诊患者进行长期治疗的效果。在100名年龄在60 - 83岁的门诊患者中,69名受试者完成了为期一年的研究。退出研究的主要原因有:患者依从性差(12%)、严重副作用(11%)、单一疗法无效(5%)以及其他原因(3%)。另外20名受试者出现了不太严重的不良反应。经过一年的治疗,除碱性磷酸酶升高外,内环境稳定的血液学和生化参数并未恶化。每日规律服用剂量为20 - 80毫克(平均 = 46.0毫克)的药物可使血压水平显著降低,并改善心功能指标(心输出量和射血分数)。相比之下,科达芬并未缩小自动记录的极端血压值之间的差异,也未使左心室质量和心律失常出现显著消退。硝苯地平用于老年患者的轻度或中度高血压,约70%的患者可能适合采用这种单一疗法。该年龄组更高的治疗积极性和更好的药物耐受性可能会进一步提高这种疗效。

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