Kellaway G S
Department of Pharmacology and Clinical Pharmacology, University of Auckland, New Zealand.
Eur J Clin Pharmacol. 1993;44(4):377-9. doi: 10.1007/BF00316476.
The efficacy of cilazapril monotherapy and in combination with hydrochlorothiazide 12.5 mg was compared in a multicentre, double blind, randomised parallel group study in 87 patients with mild to moderate essential hypertension over 8 weeks. After a 2 week single blind placebo run-in period, patients received either 2.5 mg cilazapril or 2.5 mg cilazapril plus 12.5 mg hydrochlorothiazide once daily. At Week 4 the cilazapril dose was increased from 2.5 mg to 5.0 mg if the mean sitting diastolic blood pressure was greater than 90 mmHg or had not decreased by more than 10 mmHg. After 8 weeks treatment 72% of patients responded to 2.5 mg cilazapril increasing to 88% with cilazapril 5.0 mg. For cilazapril plus hydrochlorothiazide, 83% responded to 2.5 mg cilazapril increasing to 96% on 5.0 mg cilazapril. The high response rate to low dose cilazapril monotherapy and hydrochlorothiazide combination therapy has important implications for minimising the cost of therapy with ACE inhibitors.
在一项针对87例轻至中度原发性高血压患者的多中心、双盲、随机平行组研究中，比较了西拉普利单药治疗以及与12.5毫克氢氯噻嗪联合治疗8周的疗效。在为期2周的单盲安慰剂导入期后，患者每日接受2.5毫克西拉普利或2.5毫克西拉普利加12.5毫克氢氯噻嗪治疗。如果平均坐位舒张压大于90毫米汞柱或下降幅度未超过10毫米汞柱，则在第4周时将西拉普利剂量从2.5毫克增加至5.0毫克。治疗8周后，72%的患者对2.5毫克西拉普利有反应，使用5.0毫克西拉普利时这一比例增至88%。对于西拉普利加氢氯噻嗪治疗，2.5毫克西拉普利的反应率为83%，使用5.0毫克西拉普利时增至96%。低剂量西拉普利单药治疗和氢氯噻嗪联合治疗的高反应率对于将ACE抑制剂治疗成本降至最低具有重要意义。
