頁籤選單縮合
題名 | Comparison of Clinical Efficacy and Adverse Effects between Extended-release Felodipine and Slow-release Diltiazem in Patients with Isolated Systolic Hypertension=延緩釋出型felodipine與緩慢釋出型diltiazem對孤立性收縮性高血壓病人之臨床治療效果與副作用之比較 |
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作者 | 陳銘賢; 林芬瓊; 吳德朗; | 書刊名 | 長庚醫學 |
卷期 | 22:1 1999.03[民88.03] |
頁次 | 頁44-51 |
分類號 | 418.221 |
關鍵詞 | 延緩釋出型felodipine; 緩慢釋出型diltiazem; 孤立性收縮性高血壓; Extended-release felodipine; Slow-release diltiazem; Isolated systolic hypertension; |
語文 | 英文(English) |
中文摘要 | 背景:孤立型收縮性高血壓(ISH)是心臟血管疾病的一項重要之危險因子。延緩 釋出型的 felodipine ( felodipine ER )是一種具有血管選擇性的 dihydropyridine 類 鈣離子阻斷劑並且被確認為一種安全而有效的抗 ISH 藥物。 緩慢釋出型 diltiazem ( diltiazem SR )是一種在藥理學上與 felodipine ER 作用迥異的鈣離子阻斷劑。而此藥物 對 ISH 之效用尚未有臨床報告。 方法:70 位 ISH 病患接受評估治療前後之坐姿血壓、心率、體重、不良反應與血清生化( 34 人接受 felodipine ER,而 36 人接受 diltiazem SR 各 10 星期)。 每位病患開始時 每日服用一次 5mg 的 felodipine ER 或 90 mg 的 diltiazem SR。當血壓未到達治療目標 時,其治療劑量則增加為每日兩次劑量。 結果:在治療過程中,有5位服用felodipine ER與4位服用diltiazem SR的病患由於無法忍 受副作用而必須中斷治療。 經過 10 星期的治療後, 使用 5 到 10 mg 的 felodipine ER 的高血壓病患中有 67.6 %的人之血壓得以控制。 而接受 90 到 180 mg diltiazem SR 的 病人中, 58.3 %血壓得到良好的控制。 當治療結束時, felodipine ER 將血壓由治療前 187 ╱ 83 毫米汞柱降低到 149 ╱ 74 毫米汞柱, 而 diltiazem SR 則將血壓由治療前之 185 ╱ 84 毫米汞柱降低到 158 ╱ 78 毫米汞柱(兩組之差異無統計學意義)。 兩組病患 之心率在治療過程中無有意義的變化。 就整體而言, 兩組病患有相同比率發生副作用( 50.0 %比 50.0 %),而兩組病患之副作用型式大致相同。 兩種治療藥物對病患之血中生 化並無不良的影響。 結論:felodipine ER和diltiazem SR效用相當,都可以作為ISH有效的單一治療藥物。 |
英文摘要 | Background: Isolated systolic hypertension (ISH) is a risk factor for cardiovascular disease. Extended-release felodipine (felodipine ER) has been shown to be effective in the treatment of ISH in Caucasians. However, its pharmacological properties are different from another calcium blocker, diltiazem. Also, the effectiveness, tolerability, and adverse reactions of these two antihypertensive agents for ISH have not been thoroughly assessed in Chinese. Methods: Sitting blood pressures (BP), heart rate, body weight, adverse reactions, and serum biochemistry were assessed in 70 patients with isolated systolic hypertension (34 treated with felodipine ER and 36 slow-release diltriazem [diltiazem SR] for 10 weeks). Each patient was given 5 mg of felodipine ER or 90 mg of diltiazem SR once daily and was doubled to twice daily if necessary. Results: Five patients on felodipine ER and four on diltiazem SR withdrew because of intolerable side effects. By ten weeks, 67.6% of the patients responded to a daily dose of 5-10 mg of felodipine ER and 58.3% to a daily dose of 90-180 mg of diltiazem SR. At the end of treatment, felodipine ER lowered the mean BP from 187/83 mmHg at baseline to 149/74 mmHg, whereas diltiazem SR decreased the BP from 185/84 mmHg to 158/78 mmHg (not significant between the two groups). The heart rate did not change significantly in either group. Overall, these two groups of patients had the same rate of adverse reactions (50.0% vs. 50.0%) with similar profiles of the adverse effects. Conclusion: Equivalent doses of felodipine ER and diltiazem SR are effective first-line monotherapeutic agents for the treatment of ISH. |
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