Kohara K, Hara-Nakamura N, Takada Y, Iwata T, Ochi T, Kukita H, Muneta S, Hiwada K
2nd Department of Internal Medicine, Ehime University School of Medicine, Japan.
Int J Clin Pharmacol Ther. 1996 Sep;34(9):380-3.
The effect of administration of an angiotensin-converting enzyme inhibitor, alacepril, on 24-hour blood pressure in the elderly hypertensive patients was investigated. Thirteen elderly hypertensive patients (mean age 71 +/- 5; 6 male and 7 female) participated in the present study. After 2 weeks of control period alacepril was administered 25-50 mg/day for 8 weeks. Ambulatory blood pressure monitoring with cuff-oscillometric method was performed at the end of both control and treatment periods. Alacepril administration for 8 weeks significantly decreased 24-hour blood pressure while it had little effect on heart rate. Daytime blood pressure was significantly decreased from 154 +/- 10/91 +/- 5 mmHg to 145 +/- 8/85 +/- 5 mmHg, while the change in nocturnal blood pressure was not significant: from 137 +/- 17/79 +/- 7 mmHg to 130 +/- 15/75 +/- 9 mmHg. Hyperbaric area of systolic blood pressure was also significantly decreased (from 295 +/- 185 mmHg x hour/day to 172 +/- 111 mmHg x hour/day), indicating that pressure load to the heart was effectively reduced. Administration of alacepril did not cause tachycardia in response to the decrease in blood pressure. Acrophase of both blood pressure and heart rate was changed to 11:00 a.m. These findings indicate that blockade of the renin-angiotensin system in the elderly hypertensive patients decreased blood pressure effectively without causing tachycardia or deterioration of diurnal variations of blood pressure. These hemodynamic changes produced by alacepril administration are favorable for the treatment of the elderly patients with cardiovascular disease.
研究了血管紧张素转换酶抑制剂阿拉普利对老年高血压患者24小时血压的影响。13名老年高血压患者（平均年龄71±5岁；6名男性和7名女性）参与了本研究。在2周的对照期后，给予阿拉普利25 - 50毫克/天，持续8周。在对照期和治疗期结束时，采用袖带振荡法进行动态血压监测。阿拉普利治疗8周可显著降低24小时血压，而对心率影响较小。日间血压从154±10/91±5毫米汞柱显著降至145±8/85±5毫米汞柱，而夜间血压变化不显著：从137±17/79±7毫米汞柱降至130±15/75±9毫米汞柱。收缩压的高压区也显著降低（从295±185毫米汞柱×小时/天降至172±111毫米汞柱×小时/天），表明心脏的压力负荷得到有效降低。阿拉普利给药未因血压下降而引起心动过速。血压和心率的相位均变为上午11:00。这些发现表明，老年高血压患者肾素 - 血管紧张素系统的阻断可有效降低血压，而不会引起心动过速或血压昼夜变化的恶化。阿拉普利给药所产生的这些血流动力学变化有利于老年心血管疾病患者的治疗。
