Neutel J M, Smith D H, Lefkowitz M P, Cargo P, Alemayehu D, Weber M A
Hypertension Center, VA Medical Center, Long Beach, CA 90822, USA.
J Hum Hypertens. 1995 Sep;9(9):723-7.
Calcium channel blockers are increasingly used to treat hypertension in elderly patients. To assess the effects of low-dose, long-acting verapamil on blood pressure (BP) and quality of life (QOL) in elderly patients, verapamil 120-240 mg of placebo was given once daily for 8 weeks to 76 patients aged > or = 60 years. After a 4-week placebo wash-out period, patients with a sitting DBP of 95-110 mm Hg and a mean daytime (6 am to 6 pm) ambulatory DBP > or = 90 mm Hg were entered into the study. Twenty four-hour BP monitoring as well as QOL self-assessment and digit span testing of cognitive function were performed at the end of the placebo wash-out and double-blind treatment periods. Patients treated with verapamil showed a significant decrease in mean whole-day BP, while those treated with placebo showed a small increase in BP. Treatment differences between the two groups in SBP and DBP were each statistically significant (P < 0.01). Significant differences were also seen when the 24 h period was divided into daytime and night-time readings. Both QOL and digit span testing scores were unchanged from baseline for verapamil-treated patients and were not different from the placebo-treated group. The results of this study demonstrate consistent and significant decreases in BP throughout the 24 h period with no adverse effects on QOL or cognitive function this this formulation of verapamil in elderly hypertensive patients.
钙通道阻滞剂越来越多地用于治疗老年患者的高血压。为了评估小剂量长效维拉帕米对老年患者血压（BP）和生活质量（QOL）的影响，对76例年龄≥60岁的患者给予每日一次120 - 240 mg维拉帕米或安慰剂，持续8周。在4周的安慰剂洗脱期后，坐位舒张压为95 - 110 mmHg且平均日间（上午6点至下午6点）动态舒张压≥90 mmHg的患者进入研究。在安慰剂洗脱期和双盲治疗期结束时进行24小时血压监测以及生活质量自我评估和认知功能的数字广度测试。接受维拉帕米治疗的患者全天平均血压显著下降，而接受安慰剂治疗的患者血压略有升高。两组收缩压和舒张压的治疗差异均具有统计学意义（P < 0.01）。当将24小时分为日间和夜间读数时，也观察到显著差异。维拉帕米治疗患者的生活质量和数字广度测试分数与基线相比没有变化，且与安慰剂治疗组没有差异。这项研究的结果表明，这种维拉帕米制剂在老年高血压患者中可使24小时内血压持续显著下降，且对生活质量或认知功能没有不良影响。
