硝苯地平控释剂和缓释剂高血压治疗时肾素、血管紧张素Ⅱ、儿茶酚胺及醛固酮的变化

Effect of Plasma Renin Activity,AngiotensinⅡ,and Catechlamine in Treatment of Hypertension with Nifedipine(GITS and Retard)

硝苯地平控释剂和缓释剂高血压治疗时肾素、血管紧张素Ⅱ、儿茶酚胺及醛固酮的变化王旭１张敏２邵一兵１许琳１王晏平１逄金塔１张放１宋文宣１（１．青岛市立医院心内科２６６０１１２．青岛医学院附属医院内分泌科２６６００３）ＥｆｅｃｔｏｆＰｌａｓｍａＲｅｎｉｎＡ...

Aim To investigate the curative efficacy,safety and neuroendocrine effect of nifedipine GITS with those of nifedipine retard in treatment of essential mild moderate hypertension. Methods 119 patients with hypertension were randomly classified into the following 3 groups; (1)Nifedipine GITS group,30 mg 1/d;(2)Nifedipine retard group,20 mg 2/d;(3)Placebo group.\ Blood pressure,heart rate,body weight and adverse effects were assessed at each visit.\ Plasma renin activity(PRA),angiotensin Ⅱ(AngⅡ),plasma aldosterone(Ald),plasma noradrenaline(NE) and adrenaline(E) were measured with radioimmunoassay and high performance liquid chromatography. Results Starting hypotensive time of nifedipine GITS group was similar to that of nifedipine retard group,but its range of blood pressure fluctuation(5 6±2 8/3 8±2 0 mmHg) was significantly smaller than that of nifedipine retard group(14 0±6 0/10 1±3 4 mmHg).\ On the other hand,nifedipine GITS didn′t have apparent hypertensive rebound effects when dosing is suddenly stopped,and its adverse effects of headache,dizziness and flushing were fewer than those of nifedipine retard group.\ PRA,Ald and E were significantly higher than those before treatment but neuroendocrine change of nifedipine GITS group was smooth. Conclusion The antihypertensive actions of nifedipine GITS were fast and lasting.\ Its range of blood pressure fluctuation was small and adverse effects related to vasodilation were few.\ It didn′t influence neuroendocrine changes and didn′t have apparent hypertensive rebound effects after stopping of the treatment.