Chan J C, Critchley J A, Lappe J T, Raskin S J, Snavely D, Goldberg A I, Sweet C S
Department of Clinical Pharmacology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
J Hum Hypertens. 1995 Sep;9(9):765-71.
This study investigated the anti-hypertensive efficacy and tolerability of once-daily losartan potassium (50 mg titrated to 100 mg), an angiotensin II receptor antagonist, compared with once daily felodipine extended release (ER) (5 mg titrated to 10 mg), a calcium channel blocker, after 12 weeks of therapy in elderly hypertensive patients. Following a 4-week, single-blind, placebo baseline period, qualifying patients were randomly allocated to 12 weeks of double-blind treatment with losartan potassium or felodipine ER. After 6 weeks, patients with a 24 h post-dose sitting diastolic blood pressure > or = 90 mm Hg had their dose doubled for the remaining 6 weeks. At 6 weeks, there was a greater BP response for felodipine ER than losartan potassium in elderly patients with mild to moderate hypertension. However, after 12 weeks of therapy, losartan potassium reduced BP as effectively as felodipine ER with no differences in mean BP reduction or anti-hypertensive response category between treatment groups. In this study, both treatments were well tolerated; felodipine ER was associated with a numerically higher incidence of headache and oedema while the incidence of asthenia was numerically higher in losartan-treated patients.
本研究调查了老年高血压患者接受12周治疗后,每日一次服用氯沙坦钾(50毫克,滴定至100毫克)(一种血管紧张素II受体拮抗剂)与每日一次服用非洛地平缓释片(5毫克,滴定至10毫克)(一种钙通道阻滞剂)相比的降压疗效和耐受性。在为期4周的单盲安慰剂基线期之后,符合条件的患者被随机分配接受氯沙坦钾或非洛地平缓释片12周的双盲治疗。6周后,给药后24小时坐位舒张压≥90毫米汞柱的患者在剩余6周内将剂量加倍。在6周时,对于轻度至中度高血压的老年患者,非洛地平缓释片的血压反应大于氯沙坦钾。然而,经过12周的治疗,氯沙坦钾降低血压的效果与非洛地平缓释片相同,治疗组之间的平均血压降低或降压反应类别没有差异。在本研究中,两种治疗的耐受性都很好;非洛地平缓释片导致的头痛和水肿发生率在数值上较高,而氯沙坦治疗的患者乏力发生率在数值上较高。