Zanchetti A
Istituto di Clinica Medica Generale e Terapia Medica, Universita di Milano, Italy.
Cardiovasc Drugs Ther. 1995 Aug;9 Suppl 3:529-31. doi: 10.1007/BF00877865.
The VHAS (Verapamil-Hypertension Atherosclerosis Study) Investigators entered 1464 patients with essential hypertension and blood pressure (BP) values > or = 160 mmHg systolic and 95 mmHg diastolic (DBP) but excluded those with a DBP > or = 115 mmHg, and those with diabetes mellitus or previous myocardial infarction or cerebrovascular episodes. Patients were randomly allocated to drug therapy for 2 years with either slow-release verapamil 240 mg once daily or chlorthalidone 25 mg once daily, with nonresponders receiving additional captopril 25 mg daily. A random group of eligible patients (n = 494) was followed for a more extended period (4 years) using beta-mode ultrasound. The end point is the development of atherosclerosis detected by ultrasound imaging. The most interesting observation thus far is that in this population of middle-aged hypertensives without a history of previous cardiovascular events, about two thirds had asymptomatic carotid alterations. The study is ongoing.
维拉帕米-高血压动脉粥样硬化研究（VHAS）的研究人员纳入了1464例原发性高血压患者，其收缩压≥160 mmHg且舒张压≥95 mmHg，但排除了舒张压≥115 mmHg的患者，以及患有糖尿病、既往有心肌梗死或脑血管疾病发作的患者。患者被随机分配接受为期2年的药物治疗，其中一组每日服用一次240 mg缓释维拉帕米，另一组每日服用一次25 mg氯噻酮，无反应者每日加用25 mg卡托普利。一组随机选取的符合条件的患者（n = 494）使用β模式超声进行了更长时间（4年）的随访。终点是通过超声成像检测到的动脉粥样硬化的发展。迄今为止最有趣的观察结果是，在这群无既往心血管事件病史的中年高血压患者中，约三分之二有无症状颈动脉病变。该研究仍在进行中。
