Comparison of First-Line Antihypertensive Drugs by a Randomized Cross-Over Method
A Preliminary Report
1995 年 18 巻 4 号 p. 303-305
詳細
1995 年 18 巻 4 号 p. 303-305
The present study was undertaken to compare the effects of first-line antihypertensive drugs in Japanese patients. Four antihypertensive drugs were studied: trichlormethiazide (TCT), nifedipine retard (NIF), atenolol (ATN), and enalapril malate (ENP). Thirty-eight patients (16 men and 22 women; age, 53.3± 8.8 years, mean±SD) were enrolled in the study. After a control period of 2 to 4 weeks, the four drugs were administered according to a randomized, cross-over design, the duration of each treatment period being 8 to 12 weeks. The initial dose of each drug was increased until blood pressure (BP) fell to less than 150/90mmHg. The maximum doses of TCT, NIF, ATN, and ENP were 4, 40, 50, and 20mg/day, respectively. The protocol was completed in 25 of the 38 patients. The BPs (SBP/DBP) at the end of each period were 168±3 (mean±SEM)/105±1 (control), 149±4/98±2 (TCT), 138±3/89±2 (NIF), 151 ±4/94±2 (ATN), and 152±4/97±2mmHg (ENP). The BP during NIF treatment was significantly lower than during the other treatments. This finding suggests that the calcium antagonist had a greater hypotensive effect than the other first-line antihypertensive drugs studied. The subjects seem to more closely resemble black rather than white populations with respect to their response to antihypertensive treatment. (Hypertens Res 1995; 18: 303-305)
