Widimský J, Dzúrik R
Klinika kardiologie, IKEM, Praha.
Vnitr Lek. 1998 Jun;44(6):326-31.
The TEAM trial investigated the effectiveness and tolerance of a fixed combination of the ACE inhibitor and calcium channel blocker (2 mg trandolapril and 180 mg verapamil retard) (preparation Tarka) in an open multicentre prospective study of treatment of moderately severe hypertension (diastolic pressure at the end of the two-week wash-out period 100-115 mm Hg). The trial comprised 163 patients who were treated first for four weeks by a monotherapy with 2 mg trandolapril. After these four weeks patients who attained normal blood pressure proceeded with trandolapril treatment. Hypertensive patients who did not attain normal diastolic pressure levels were treated for another four weeks by a fixed combination of trandolapril and verapamil SR. After four weeks of treatment with trandolapril 62 patients of 163 (37%) had a diastolic blood pressure of less than 90 mm Hg. The fixed combination of trandolapril and verapamil SR reduced the diastolic blood pressure to less than 90 mm Hg in 71.6% of the patients resistant to treatment with 2 mg trandolapril and in another 15.6% of patients it reduced the diastolic blood pressure by 10 mm Hg or more. After two months of treatment 60 patients had a normal blood pressure due to trandolapril (37%) and another 73 patients (45%) treated by a combination of trandolapril and verapamil SR, i.e. a total of 133 patients (82%) who originally suffered from moderately severe hypertension, attained a normal diastolic blood pressure. The mean decrease of diastolic pressure after two months of treatment was 19.5 mm Hg in "non-respondents" to trandolapril monotherapy and 23.6 mm Hg in "respondents". The mean decrease of systolic pressure in "non-respondents" and "respondents" after trandolapril treatment was 19.5 mm Hg and 35.0 mm Hg resp. The fixed combination of trandolapril and verapamil was not only effective but was associated with a minimum of undesirable effects. The incidence of headaches declined significantly. The combination of the above preparations is useful also because both preparations have a cardio- and nephroprotective effect and do not affect the lipid and carbohydrate metabolism. Treatment with a fixed combination of trandolapril and verapamil SR is indicated in moderately severe hypertension not responding to monotherapy, in particular when associated with diabetes, hyperlipoproteinaemia, ischaemic heart disease or left ventricular hypertrophy.
在一项开放的多中心前瞻性研究中，TEAM试验调查了血管紧张素转换酶（ACE）抑制剂与钙通道阻滞剂的固定组合（2毫克群多普利和180毫克缓释维拉帕米）（商品名Tarka）治疗中度严重高血压（两周洗脱期结束时舒张压为100 - 115毫米汞柱）的有效性和耐受性。该试验纳入了163例患者，首先用2毫克群多普利进行单药治疗4周。4周后，血压恢复正常的患者继续接受群多普利治疗。舒张压未达到正常水平的高血压患者再用群多普利与维拉帕米缓释剂的固定组合治疗4周。用群多普利治疗4周后，163例患者中有62例（37%）舒张压低于90毫米汞柱。群多普利与维拉帕米缓释剂的固定组合使71.6%对2毫克群多普利治疗耐药的患者舒张压降至90毫米汞柱以下，另有15.6%的患者舒张压降低了10毫米汞柱或更多。治疗两个月后，60例患者（37%）因群多普利血压恢复正常，另有73例患者（45%）通过群多普利与维拉帕米缓释剂联合治疗血压恢复正常，即最初患有中度严重高血压的133例患者（82%）舒张压恢复正常。在群多普利单药治疗“无反应者”中，治疗两个月后舒张压平均下降19.5毫米汞柱，“有反应者”中为23.6毫米汞柱。群多普利治疗后，“无反应者”和“有反应者”收缩压平均下降分别为19.5毫米汞柱和35.0毫米汞柱。群多普利与维拉帕米的固定组合不仅有效，而且不良反应最少。头痛发生率显著下降。上述制剂的组合也很有用，因为两种制剂都具有心脏和肾脏保护作用，且不影响脂质和碳水化合物代谢。群多普利与维拉帕米缓释剂的固定组合适用于对单药治疗无反应的中度严重高血压，特别是伴有糖尿病、高脂蛋白血症、缺血性心脏病或左心室肥厚的患者。
