维拉帕米抗高血压作用及其对肾素系统活性的影响

Antihypertensive Effects of Verapamil and It's Effect on Renin-Angiotensive-Aldosterone System Activity

采用单盲随机研究方法，观察５０例不同分期的高血压患者服用维拉帕米的降压效果，并检测治疗前后血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡＴⅡ）、醛固酮（ＡＬＤ）和心钠素（ＡＮＰ）的浓度，旨在探讨维拉帕米对肾素系统（ＲＡＡＳ）活性的影响。研究结果表明：（１）维拉帕米治疗后，收缩压和舒张压较治疗前均有非常显著的下降（Ｐ＜０．０１）。（２）维拉帕米治疗高血压总有效率８８．０％，各期之间疗效无显著性差异（Ｐ＞０．０５）。（３）高血压组ＰＲＡ、ＡＴⅡ、ＡＬＤ和ＡＮＰ浓度均高于正常对照组（Ｐ＜０．０１）。（４）治疗后ＰＲＡ、ＡＴⅡ、ＡＬＤ和ＡＮＰ浓度均降低，治疗前后比较均有显著性差异（Ｐ＜０．０１）。提示维拉帕米降压机制除阻断钙离子内流以外，可能与其抑制ＲＡＡＳ活性有关。

Using single-blind and randomized methods we observed the antihypertensive effcts of verapamil in 50 patients with hypertension stage Ⅰ to Ⅲ to study it's effect on RAAS activity. The plasma levels of PRA, ATⅡ,ALD and ANP were measured before and after treatment. The results showed : (1) After treatment with verapamil, systolic and diastolic blood pressure were decreased obviously (P<0. 001):(2) The totall effective rate was 88.0%.There were no significant differences of drug effect between patients with different stages (P>0. 05); (3)The plasma levels of PRA, AT Ⅱ, ALD and ANP in patients with hypertension were significantly higher than those in normotensive controls (P< 0. 01);(4) After treatment, the plasma levels of PRA, ATⅡ, ALD and ANP were decreased, significantly lower than those before treatment (P<0. 01). The results indicate that verapamil reduces blood pressure not only by blocking Ca[2+] influx but also by inhibiting RAAS activity.