Shimamoto H, Shimamoto Y
Department of Cardiovascular Medicine, PIA Nakamura Hospital, Hiroshima, Japan.
Hypertension. 1995 Mar;25(3):327-34. doi: 10.1161/01.hyp.25.3.327.
We compared the systemic and regional hemodynamic effects of nifedipine and lisinopril in 26 elderly hypertensive patients with the use of the pulsed Doppler ultrasound technique. Nifedipine is a dihydropyridine calcium antagonist, and lisinopril is an angiotensin-converting enzyme inhibitor. The study had a single-blind crossover design: nifedipine and lisinopril were given for 8 weeks each after washout periods of 4 weeks. Both nifedipine and lisinopril significantly reduced mean arterial pressure to the same extent (P < .01); cardiac output remained unchanged in both nifedipine- and lisinopril-treated groups. Lisinopril increased renal flow significantly (P < .01), but nifedipine did not. Common carotid, vertebral, celiac, and superior mesenteric arterial and diaphragmatic and terminal aortic flows did not show a significant change with either nifedipine or lisinopril. The specific action of lisinopril on the thoracic aorta was a marked improvement of aortic compliance compared with nifedipine, which might be partly responsible for an increase in renal flow. Lisinopril may provide more desirable regional hemodynamic effects and additional benefits for elderly hypertensive patients.
我们使用脉冲多普勒超声技术比较了硝苯地平和赖诺普利对26例老年高血压患者的全身和局部血流动力学影响。硝苯地平是一种二氢吡啶类钙拮抗剂，赖诺普利是一种血管紧张素转换酶抑制剂。本研究采用单盲交叉设计：在4周的洗脱期后，硝苯地平和赖诺普利各给药8周。硝苯地平和赖诺普利均能显著降低平均动脉压，且降低程度相同（P <.01）；硝苯地平和赖诺普利治疗组的心输出量均保持不变。赖诺普利显著增加肾血流量（P <.01），但硝苯地平无此作用。硝苯地平和赖诺普利对颈总动脉、椎动脉、腹腔动脉、肠系膜上动脉以及膈下和主动脉末端血流均无显著影响。与硝苯地平相比，赖诺普利对胸主动脉的特定作用是显著改善主动脉顺应性，这可能是肾血流量增加的部分原因。赖诺普利可能为老年高血压患者提供更理想的局部血流动力学效应和额外益处。
