Weir M R, Saunders E
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
J Hum Hypertens. 1998 Mar;12(3):189-94. doi: 10.1038/sj.jhh.1000578.
The angiotensin-converting enzyme (ACE) inhibitor trandolapril, a non-sulfhydryl prodrug which is hydrolysed into trandolaprilat, was studied in 322 hypertensives of African-American descent using a double-blind, randomised, placebo-controlled, parallel study design. Following 6 weeks of double-blind treatment with placebo or 0.25 to 16 mg/day trandolapril, an analysis of drug effect on trough blood pressure (BP) stratified by age, gender, weight, pre-treatment plasma renin activity, and trandolaprilat concentration was performed. Two mg was the lowest effective trandolapril dose, whereas doses above 4 mg did not significantly reduce trough BP. Reduction in BP did not correlate with trough plasma trandolaprilat concentration. Pre-treatment plasma renin activity was not a reliable indicator of anti-hypertensive response, as similar reductions in BP occurred even in patients with the lowest renin levels. There were no observable differences based on age, gender or measurements of the renin-angiotensin-aldosterone axis. In conclusion, neither age, gender or plasma renin activity influenced anti-hypertensive response to angiotensin-converting enzyme inhibition in African-Americans.
对322名非裔美国高血压患者采用双盲、随机、安慰剂对照、平行研究设计，研究了血管紧张素转换酶（ACE）抑制剂群多普利，一种非巯基前药，可水解为群多普利拉。在接受安慰剂或0.25至16毫克/天群多普利双盲治疗6周后，对药物对谷血压（BP）的影响进行了分析，按年龄、性别、体重、治疗前血浆肾素活性和群多普利拉浓度进行分层。2毫克是群多普利的最低有效剂量，而4毫克以上的剂量并未显著降低谷血压。血压降低与谷血浆群多普利拉浓度无关。治疗前血浆肾素活性不是抗高血压反应的可靠指标，因为即使在肾素水平最低的患者中也出现了类似的血压降低。基于年龄、性别或肾素-血管紧张素-醛固酮轴的测量没有观察到差异。总之，年龄、性别或血浆肾素活性均未影响非裔美国人对血管紧张素转换酶抑制的抗高血压反应。
