López N C, Corral J L, Perozo M, García P, Bustillo N, Arreaza M R, Arocha I
Unidad de Hipertensión Arterial, Hospital Central de Maracay, Estado Aragua, Venezuela.
Rev Esp Cardiol. 1997 Aug;50(8):567-72. doi: 10.1016/s0300-8932(97)73265-2.
Moderate-to-severe hypertension is less prevalent than mild hypertension, but it is responsible for more incidences of complications. Its complex treatment requires several drugs, and is often inadequate. This study assessed the efficacy and safety of nifedipine GITS (oral release osmotic system) as monotherapy, in addition to the effects on left ventricular hypertrophy, after a long term follow-up (one year).
Thirty patients with diastolic blood pressure above 105 mmHg were studied after a short placebo phase. They received nifedipine GITS as monotherapy in a single daily dose of 30 mg; dose titration was made the first three months according to response and until they reached figures equal to or below 95 mmHg. By M-Mode echocardiogram, left ventricular mass index and systolic function were calculated at the end of the placebo phase and at 3, 6, 9 and 12 months. Hematological parameters, lipid profile, electrolytes and liver enzymes were assessed at the same periods.
In 70% of the patients the blood pressure reached values of 140-90 mmHg. In 16 patients with adequate M-mode recordings, a 12% reduction in left ventricular mass was observed without modification in systolic function. Five patients were retired: two due to adverse events and three due to different reasons (drop out, evidence for secondary hypertension). There were no changes of clinical significance in the hematological or biochemical parameters and no hypertensive crisis occurred.
The monotherapy with nifedipine GITS was effective in reducing high blood pressure, induced regression in ventricular hypertrophy and showed good tolerance in one year follow-up.
中重度高血压的患病率低于轻度高血压，但其导致的并发症发生率更高。其复杂的治疗需要多种药物，且往往并不充分。本研究评估了硝苯地平控释片（口服渗透系统）单药治疗的疗效和安全性，以及长期随访（一年）后对左心室肥厚的影响。
在经过短期安慰剂阶段后，对30例舒张压高于105mmHg的患者进行了研究。他们接受硝苯地平控释片单药治疗，每日单次剂量为30mg；在最初三个月根据反应进行剂量滴定，直至血压降至95mmHg及以下。通过M型超声心动图，在安慰剂阶段结束时以及第3、6、9和12个月计算左心室质量指数和收缩功能。在同一时期评估血液学参数、血脂谱、电解质和肝酶。
70%的患者血压降至140 - 90mmHg。在16例有足够M型记录的患者中，观察到左心室质量减少了12%，而收缩功能无改变。5例患者退出研究：2例因不良事件，3例因不同原因（退出、继发性高血压证据）。血液学或生化参数无具有临床意义的变化，也未发生高血压危象。
硝苯地平控释片单药治疗在降低高血压方面有效，可使心室肥厚消退，且在一年的随访中显示出良好的耐受性。
