非洛地平，氨氯地平对高血压病患者24小时血压的影响

目的：比较非洛地平,氨氯地平对高血压病患者24小时血压的降压疗效。方法：采用随机、单盲和平行对照的方法,运用24小时动态血压监测。结果：二药均能显著降低血压、彼此间降低偶测血压的幅度无显著差异。二药均能降低24小时平均,白天平均及夜间平均血压、均能有效控制清晨血压高峰期的血压。结论：非洛地平,氨氯地平均可每日服用1次,均能有效控制24小时血压及清晨醒后的高峰期血压。     

用动态血压监测比较国产与进口苯磺酸氨氯地平降压疗效

目的比较国产与进口苯磺酸氨氯地平对原发性高血压患者24小时血压的降压疗效.方法采用多中心,随机开放平行对照方法,运用24小时ABPM测压法.结果两药均能显著降低血压,彼此间降压幅度无显著差异.两药均能降低24小时平均、白天平均及夜间平均血压,均能有效控制清晨高峰期血压.结论国产与进口苯磺酸氨氯地平均能有效控制24小时血压及清晨后的高峰期血压.     

非洛地平缓释片、比索洛尔和培哚普利对原发性高血压患者24小时血压的影响

目的 :比较非洛地平缓释片、比索洛尔和培哚普利对 48例原发性高血压患者的降压疗效。方法 :采用随机 ,单盲和平行对照的方法 ,运用 2 4小时动态血压监测之。结果 :3种药均能显著降低血压 ,彼此间降低偶测血压的幅度无显著差异。非洛地平缓释片和比索洛尔降低 2 4小时平均和白天平均血压的幅度大于培哚普利。 3种药均能有效控制清晨高峰期的血压 ,它们的降压谷 /峰比值都超过 6 5 %。结论 :非洛地平缓释片、比索洛尔和培哚普利均可每日服用 1次 ,前 2种药控制 2 4小时血压及清晨醒后的高峰期血压较后者为佳。     

非洛地平缓释片,比索洛尔和培哚普利对原发性高血压患者24小时血？…

目的：比较非洛地平缓释片、比索洛尔和培哚普利对４８例原发性高血压患的降压疗效。方法：采用随机,单盲和平行对照的方法,运用２４小时动态血压监测之。结果：３种药均能显降低血压,彼此间降低偶测血压的幅度无显差异,非洛地平缓释片和比索洛尔降低２４小时平均和白天平均血压的幅度大于培哚普利。３种药均能有效控制清晨高峰期的血压,它们的降压谷／峰比值都超过６５％。结论：非洛地平缓释片、比索洛尔和培哚普利均可     

比索洛尔、拉西地平和赖诺普利对高血压病患者24小时血压的影响

目的比较比索洛尔、拉西地平和赖诺普利对２９例高血压病患者的降压疗效。方法采用随机、单盲和交叉的方法，运用２４小时动态血压监测。结果三药均能显著降低血压，彼此间降低偶测血压的幅度无显著差异。比索洛尔和拉西地平降低２４小时平均和白天平均血压的幅度大于赖诺普利。三药均能有效控制清晨血压高峰期的血压，它们的降压谷／峰比值都超过６５％。结论比索洛尔、拉西地平和赖诺普利均可每日服用１次，前二药控制２４小时血压及清晨醒后的高峰期血压较后者为佳。     

非洛地平与赖诺普利的降压效应及对左室肥厚逆转作用的对比

目的：评价并比较非洛地平及赖诺普利治疗轻、中度原发性高血压（ＥＨ）的降压疗效及对左心室肥厚的逆转作用。方法：选择１２８例轻、中度ＥＨ患者,入选前服用安慰剂２周,随机分为非洛地平组６６例和赖诺普利组６２例。非洛地平组服用非洛地平５～１０ｍｇ／ｄ,赖诺普利组服用赖诺普利１０～２０ｍｇ／ｄ,每日１次,疗程２４周。两组均在治疗前及治疗后的２、１２、２４周分别进行偶测血压、２４ｈ动态血压及超声心动图检查。结果：非洛地平和赖诺普利均能显著降低血压,两药对偶测血压的下降幅度差异无显著性（Ｐ＞０．０５）。非洛地平能有效控制清晨高峰期血压。收缩压、舒张压的谷／峰比值分别是７２％、６７％。非洛地平降低２４ｈ平均血压和白昼血压的幅度大于赖诺普利,而夜间血压降低的幅度显著低于白昼。两药治疗２４周后,室间隔厚度、左心室后壁厚度、左室心肌重量及左室重量指数较治疗前显著改善（Ｐ＜０．００１）。两组药物副反应均较轻。结论：非洛地平能有效降低ＥＨ患者的血压,降低靶器官损害的危险性。     

苯磺酸氨氯地平片、硝苯地平控释片和非洛地平缓释片长期降压疗效的比较

目的比较苯磺酸氨氯地平片(络活喜)、硝苯地平控释片(拜新同)和非洛地平缓释片(波依定)三者在老年高血压病患者中的长期降压疗效。方法采用随机和对照的方法,通过24小时动态血压检测,分别比较服用络活喜、拜新同、波依定12个月后的疗效。结果三种药物均能有效控制24小时平均血压、白天平均血压和夜间平均血压,并维持良好的血压昼夜节律。结论络活喜、拜新同和波依定每日服用1次(1片),均能有效控制全天24小时血压。     

拉西地平治疗原发性高血压的疗效观察

目的观察拉西地平对高血压病患者的降压疗效、耐受性、谷峰比值及不良反应。方法随机入选高血压病人52例,年龄(45±11)岁,服用拉西地平2~8 mg/d,共4周,治疗前后分别监测24 h动态血压。结果服药后血压与用药前比较有显著下降,动态血压监测结果显示,治疗后昼夜平均收缩压、舒张压均明显下降,心率在用药前后无明显变化,收缩压和舒张压的谷峰比均大于50%,能有效控制清晨血压高峰期的血压。结论拉西地平治疗高血压降压疗效显著、安全,能持续24 h。     

拉西地平治疗原发性高血压的疗效观察

目的观察拉西地平对高血压病患者的降压疗效、耐受性、谷峰比值及不良反应.方法随机入选高血压病人52例,年龄(45±11)岁,服用拉西地平2～8 mg/d,共4周,治疗前后分别监测24 h动态血压.结果服药后血压与用药前比较有显著下降,动态血压监测结果显示,治疗后昼夜平均收缩压、舒张压均明显下降,心率在用药前后无明显变化,收缩压和舒张压的谷峰比均大于50%,能有效控制清晨血压高峰期的血压.结论拉西地平治疗高血压降压疗效显著、安全,能持续24 h.     

硝苯地平控释片对清晨血压和动态血压季节性变异的影响

目的比较硝苯地平控释片和非洛地平缓释片对冬夏两季清晨血压和动态血压达标率的影响。方法入选轻中度原发性高血压患者158例随机分为两组:硝苯地平组(30mg/d,n=79)和非洛地平组(5mg/d,n=79)。所有患者均于2012年秋季纳入试验,治疗至少8周后分别于冬季和夏季均行24h动态血压监测,研究周期为12个月。结果与夏季比较,两组患者冬季24h、日间、夜间平均血压显著增高,清晨血压达标率和动态血压达标率明显降低(均P0.05);尽管夏季两组血压差异无统计学意义,但硝苯地平组24h平均收缩压、24h平均舒张压、日间平均收缩压以及夜间平均收缩压的冬夏血压差值[(5.5±1.2)、(3.5±1.0)、(4.2±2.2)、(5.6±1.2)mm Hg]明显低于非洛地平组[(9.9±1.3)、(4.7±1.4)、(8.5±1.5)、(7.1±1.2)mm Hg](均P0.05)。硝苯地平组冬季清晨血压和日间收缩压的变异性[(10.3±4.2)、(8.5±3.2)mm Hg]明显低于非洛地平组[(13.3±4.4)、(10.7±3.9)mm Hg](均P0.05)。与非洛地平组相比,硝苯地平组能明显提高冬季清晨血压达标率(58.2%比41.8%,P=0.039)和冬季日间血压达标率(60.8%比43.0%,P=0.026)。另外,经多元回归分析发现,降血压药物类别、年龄、体质量指数、季节和吸烟史是影响清晨血压的主要因素。结论与非洛地平缓释片比较,硝苯地平控释片明显降低冬夏血压差值,减少血压波动,提高冬季清晨血压和日间血压达标率。     

非洛地平缓释片对原发性高血压患者动态血压的影响及与细胞内胞浆游离钙浓度的关系

目的 观察非洛地平对高血压患者动态血压的影响及与细胞内胞浆游离钙浓度的关系。方法 检测28例原发性高血压患者及相应对照组之血压及淋巴细胞胞浆游离钙浓度及非洛地平缓释片治疗四周后血压及淋巴细胞胞浆游离钙浓度的变化,并观察其治疗前后24h动态血压的变化。结果 原发性高血压患者淋巴细胞胞浆游离钙浓度显著高于对照组,非洛地平缓释片治疗后淋巴细胞胞浆游离钙浓度和血压显著下降(P<0.01),淋巴细胞胞浆游离钙浓度的下降幅度与收缩压及舒张压下降幅度呈正相关(r=O.866,P<0.001及r=0.734,P<0.001)。治疗后24h平均收缩压、24h平均舒张压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、日间收缩压负荷、日间舒张压负荷、夜间收缩压负荷、夜间舒张压负荷均较治疗前明显降低(P<0.05-P<0.01)。结论非洛地平是平稳有效的抗高血压药物,其降压作用可能是通过降低细胞内胞浆游离钙浓度而发挥作用。     

The effect of amlodipine on ambulatory blood pressure in hypertensive patients

Certain high-risk populations, such as diabetics and blacks, have sustained elevation in blood pressure and heart rate throughout the day and night, with blunting of the usual diurnal variability pattern. This may contribute to their higher incidence of left ventricular hypertrophy (blacks) and cardiovascular complications (diabetics). Hypertensives who maintain a diurnal pattern of blood pressure variation still exhibit higher daytime and nocturnal blood pressure levels than normotensives. Thus, to achieve maximum effectiveness in treating hypertension, 24-hour control of blood pressure is necessary. Antihypertensive agents should effectively reduce blood pressure consistently throughout a 24-hour period. The objective of this study was to assess the effects of amlodipine, 5 mg once daily, on blood pressure measured by 24-hour ambulatory monitoring in a randomized, double-blind, placebo-controlled single-site study. Patients with mild-to-moderate essential hypertension were randomized to receive amlodipine (n = 11) or placebo (n = 5) in a 2:1 ratio. A 4-week single-blind placebo run-in period was followed by a 4-week double-blind phase. Ambulatory monitoring of blood pressure was carried out for 24 hours at the end of each 4-week phase. Patients receiving amlodipine had significantly lower blood pressure compared with placebo 24 hours after the last dose (supine blood pressure −25.1/−10.1 mm Hg; standing blood pressure −21.2/−9.7 mm Hg) after 4 weeks of treatment. This effect was clearly demonstrated by the 24-hour postdose measurement and the mean blood pressure over the 24-hour interval as measured by ambulatory recordings. The mean hourly ambulatory recordings showed that amlodipine maintained both diastolic and systolic pressures below the baseline levels at every hour during the 24-hour observation period. Nine of 10 evaluable patients (90%) on amlodipine responded vs only 1 of 5 patients (20%) on placebo. The decrease in blood pressure for the amlodipine patients was not accompanied by a significant increase in pulse rate. Amlodipine was well tolerated; possibly drug-related side effects of intermittent headache and nocturia were experienced by 1 patient each; the latter had been present during the placebo run-in phase. Amlodipine is effective, well tolerated, and may be administered once daily for effective 24-hour blood pressure control.     

Azelnidipine and amlodipine: a comparison of their effects and safety in a randomized double-blinded clinical trial in Chinese essential hypertensive patients

The purpose of this study is to compare the effects and safety of azelnidipine and amlodipine in Chinese essential hypertensive patients. Patients were randomized to receive administration of azelnidipine 8-16 mg/day or amlodipine 2.5-5 mg/day for 8 weeks. The blood pressure and pulse rate were evaluated in an outpatient clinic and by ambulatory blood pressure monitoring. There were 220 patients enrolled to the study. The blood pressure in both groups was decreased significantly (P < 0.001). Compared with amlodipine, the patients received azelnidipine had better response in systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P < 0.01). No significant changes of pulse rate were observed in either group. For the ambulatory blood pressure monitoring, both drugs had stable anti-hypertensive effects over 24 h. The trough/peak ratios of DBP for the azelnidipine and amlodipine groups were, respectively, 46% and 40%. Adverse events occurred at 7.3% and 10.0%, respectively in the azelnidipine and amlodipine groups (P = 0.485). Headache and dizziness were observed at an incidence of more than 1% in both groups. Once-daily administration of azelnidipine effectively controlled blood pressure and had a stable action over 24 h. Azelnidipine had good safety and compliance similar to amlodipine.     

比较不同时间服用缬沙坦对高血压患者血压变异性的影响

目的比较不同时间服用缬沙坦及苯磺酸氨氯地平片对原发性高血压（高血压）患者血压变异性（bloodpressurevariability,BPV）的影响。方法采用随机数字法将120例轻一中度高血压患者分成3组,分别为日间口服缬沙坦组、夜间口服缬沙坦组、日间口服苯磺酸氨氯地平组,治疗前、后进行24h动态血压监测。以动态血压变异标准差作为血压变异性指标,比较3个月后3种治疗方案对血压及血压变异性的影响。结果3种治疗方案均能有效降低血压,与治疗前比较差异有统计学意义（P〈0．05）。在控制BPV方面,日间口服缬沙坦组的BPV改善不明显,与治疗前比较差异无统计学意义（P〉0．05）;与治疗前比较,夜间口服缬沙坦组[收缩压变异性：（11±3）mmHg眠（15±4）nlmHg（1mmHg=0．133kPa）,P〈0．05;舒张压变异性：（7±2）mmHgVS．（10±4）mmHg,P〈0．05]和苯磺酸氨氯地平组[收缩压变异性：（10±3）mmHgIJS．（16±3）mmHg,P〈0．05;舒张压变异性：（6±2）mmHgVS．（11±2）mmHg,P〈0．05]的24h动态血压变异性降低,差异有统计学意义;苯磺酸氨氯地平组在改善BPV方面仍优于夜间口服缬沙坦组,差异有统计学意义（P〈0．01）。结论与日间服药相比,夜间服用缬沙坦能更有效改善血压变异性。     

Are there differences in the effects of long-acting calcium antagonists on ambulatory blood pressure? Extended-release nisoldipine versus amlodipine as a model

BACKGROUND: Twenty-four-hour ambulatory blood pressure monitoring (ABPM), which provides important information regarding mean 24 h efficacy, variability of effect during sleeping-awake cycles, and effects on the early morning surge in blood pressure, is a sensitive method for evaluating efficacy of antihypertensive agents. Extended-release nisoldipine and amlodipine are long-acting dihydropyridine calcium antagonists used for the treatment of hypertension. Because these agents have different pharmacokinetic profiles, 24 h ABPM could provide clues regarding their different effects on blood pressure. OBJECTIVE: To assess the effects of extended-release nisoldipine and amlodipine on 24 h ambulatory blood pressure control and heart rate. METHODS: After completion of a 3-4 week placebo run-in period, 100 patients were randomly allocated to double-blind treatment with 10-40 mg extended-release nisoldipine or 2.5-10 mg amlodipine for 8 weeks, starting at the lowest dose. Medications were titrated at 2-week intervals on the basis of office blood pressures in seated patients. Twenty-four-hour ABPM was performed at placebo baseline and at the end of double-blind therapy. RESULTS: Extended-release nisoldipine and amlodipine provided equivalent mean 24 h changes in blood pressure [systolic blood pressure (SBP)/diastolic blood pressure decreases by 9.8/7.1 and 8.0/6.0 mmHg, respectively] and heart rate. These two treatments also provided similar changes in blood pressure at trough (22-24 h after dosing; decreases by 10.4/7.2 and 10.1/7.3 mmHg, respectively). The antihypertensive effects of amlodipine during the awake and sleeping intervals were similar (decreases by 9.6/5.9 and 9.9/5.8 mmHg, respectively, NS); whereas the effect of nisoldipine during the awake interval was significantly greater than its effect during the sleeping interval (decreases by 12.4/8.0 and 8.9/4.3 mmHg, respectively, P = 0.08/0.01). Furthermore, extended-release nisoldipine, but not amlodipine, blunted the rate of rise in early morning SBP. CONCLUSIONS: Extended-release nisoldipine and amlodipine have similar effects on mean 24 h and trough blood pressures. However, different effects during the sleeping and awake intervals and on the rate of rise in early morning SBP were observed with nisoldipine.     

贝那普利联合氨氯地平或氢氯噻嗪对老年高血压患者动态血压及其平滑指数的影响

目的对比贝那普利＋氨氯地平（氨氯地平组）及贝那普利＋氢氯噻嗪（氢氯噻嗪组）对老年高血压患者动态血压及其平滑指数的影响。方法选择120例老年高血压患者随机分为氨氯地平组和氢氯噻嗪组,所有病人均于治疗前及治疗6月后行动态血压检查,记录24h平均收缩压（24hSBP）及24h平均舒张压（24hDBP）、计算治疗后24h收缩压及舒张压平滑指数（SISBP和SIDSP）及谷峰比值（T／P值）,比较2组病人治疗前后动态血压及其平滑指数、T／P值的变化。结果治疗后病人血压均得到有效控制,氨氯地平组SISBP及SIDBP明显高于氢氯噻嗪组（P〈0．01或P〈0．05）,差异有统计学意义,而2组之间24hSBP及24hDBP及T／P值无显著性差异（P〉0．05）。结论氨氯地平组较氢氯噻嗪组能更平稳地降低血压,并且明显提高血压的SI。     

Persistence of the antihypertensive efficacy of amlodipine and nifedipine GITS after two 'missed doses': a randomised,double-blind comparative trial in Asian patients

Suboptimal management of hypertension is often a result of poor patient compliance in the form of missed doses of their antihypertensive medication. This multicentre, randomised, double-blind, parallel-group trial was designed to compare the persistence of the antihypertensive efficacy of the amlodipine and nifedipine gastrointestinal therapeutic system (GITS) after two 'missed doses', and also to compare the drugs' overall efficacy and safety in Asian patients with mild-to-moderate essential hypertension. Following a 2-week placebo run-in period, 222 patients were randomised to receive either amlodipine (5 mg daily, increased after 6 weeks if necessary to 10 mg daily, n=109) or nifedipine GITS (30 mg daily, increased after 6 weeks if necessary to 60 mg daily; n=113) for 12 weeks. A placebo was then substituted for further 2 days with continuous ambulatory blood pressure (BP) monitoring. The increases in the last 9 h of mean ambulatory BP on day 2 after treatment withdrawal were significantly less with amlodipine than with nifedipine GITS: 4.4+/-7.0 vs 11.2+/-11.3 mmHg for systolic BP (P相似文献   

Antihypertensive efficacy and safety of olmesartan medoxomil compared with amlodipine for mild-to-moderate hypertension

The antihypertensive efficacy of the angiotensin II receptor blocker olmesartan medoxomil has been shown to compare favourably with that of other antihypertensive agents. This randomized, double-blind study compared the antihypertensive efficacy of the starting dose of olmesartan medoxomil with that of the calcium channel blocker amlodipine besylate (amlodipine) in subjects with mild-to-moderate hypertension. Following a 4-week, single-blind, placebo run-in period, 440 subjects aged >/=18 years were randomized to the starting dose of olmesartan medoxomil (20 mg/day), amlodipine (5 mg/day), or placebo for 8 weeks. Subjects were evaluated by 24-h ambulatory blood pressure monitoring (ABPM) and by seated cuff blood pressure (BP) measurements at trough. The primary end point was the change from baseline in mean 24-h diastolic blood pressure (DBP) by ABPM at Week 8. Secondary end points included change from baseline in mean 24-h ambulatory systolic blood pressure (SBP) at 8 weeks, change from baseline in mean seated trough cuff DBP and SBP measurements, and response and control rates for DBP <90 and <85 mmHg. Control rates for SBP <140 and <130 mmHg were also calculated. Olmesartan medoxomil and amlodipine produced significantly greater reductions in ambulatory and seated DBP and SBP compared with placebo. Mean reductions in ambulatory and seated BP were similar between the two active agents; however, in the olmesartan medoxomil group, significantly more patients achieved the SBP goal of <130 mmHg and the DBP goal of <85 mmHg. Both drugs were well tolerated at the recommended starting dose. Although amlodipine was associated with a higher incidence of oedema, this did not reach statistical significance. Olmesartan medoxomil is an effective antihypertensive agent, with BP-lowering efficacy at the starting dose similar to that of amlodipine, and is associated with more patients achieving the rigorous BP goals of SBP <130 mmHg and DBP <85 mmHg.