Martínez López J J, Rúiz López F J, Gómez Márquez M, Ortega González G, Molina Boix M, Florenciano Sánchez R
Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia.
An Med Interna. 1993 Aug;10(8):386-9.
This study assessed the effectivity of the association between a diuretic, chlorthalidone, and retard nifedipine in the treatment of patients above 50 years of age with Arterial Hypertension refractory to retard nifedipine. A prospective study of a 3-month controlled intervention was designed, in which the patients were treated with retard nifedipine for 2 months and, if they did not respond to the treatment, chlorthalidone was associated for 1 month. Out of 235 patients selected at the beginning of the study, 28 dropped out voluntarily, 24 were excluded because they did not adhere to the protocol and 30 dropped out due to side effects. After the first two months of therapy, hypertension was controlled in 60.2% of the 181 patients, whereas in the third month, only in 20% of the 44 patients considered could be controlled. Significant differences were observed between the two treatments (p < 0.001) with a 95% CI in the percentage differences of 54% versus 26.4%. These results suggest that the association of chlorthalidone and retard nifedipine does not improve the treatment of Arterial Hypertension refractory to retard nifedipine.
本研究评估了利尿剂氯噻酮与缓释硝苯地平联合使用对50岁以上硝苯地平缓释片治疗无效的高血压患者的疗效。设计了一项为期3个月的对照干预前瞻性研究，患者先接受2个月的硝苯地平缓释片治疗，若治疗无效，则联合使用氯噻酮治疗1个月。在研究开始时选取的235例患者中，28例自愿退出，24例因未遵守方案被排除，30例因副作用退出。治疗前两个月后，181例患者中有60.2%的高血压得到控制，而在第三个月，在44例被纳入研究的患者中，只有20%的患者血压得到控制。两种治疗方法之间存在显著差异（p<0.001），差异百分比的95%置信区间为54%对26.4%。这些结果表明，氯噻酮与硝苯地平缓释片联合使用并不能改善硝苯地平缓释片治疗无效的高血压的治疗效果。
