Objective: To evaluate the effect of the fixed-dose combination of trandolapril/verapamil on albuminuria and renal function in patients with hypertension and type 2 diabetes mellitus unresponsive to treatment with an angiotensin-converting enzyme (ACE) inhibitor. Subjects and methods: 30 patients with type 2 diabetes mellitus and hypertension whose hypertension could not be controlled with at least 6 months’ treatment with an ACE inhibitor were treated with a combination of trandolapril/verapamil (2mg/180mg once daily). Patients were evaluated monthly over 6 months for sitting blood pressure (BP), heart rate and plasma glucose. A 24-hour urine albumin and a creatinine clearance examination were done prior to and 6 months after the use of the combination. Results: All the patients had a decrease in their BP, from a mean of 168 ± 5/93 ± 3mm Hg to 135 ± 4/79 ± 5mm Hg (p < 0.001), and in urine albumin from 4564.7 ± 563 mg/day to 2096.9 ± 296 mg/day (p < 0.001). There was no significant change in heart rate or in creatinine clearance. Conclusions: The trandolapril/verapamil combination effectively reduces high BP and albuminuria in patients with type 2 diabetes mellitus whose hypertension is unresponsive to an ACE inhibitor.
目的评估对
血管紧张素转换酶(ACE)
抑制剂治疗无效的高血压和 2 型糖尿病患者使用固定剂量曲多普利/
维拉帕米联合疗法对白蛋白尿和肾功能的影响。研究对象和方法:30 名 2 型糖尿病和高血压患者在接受至少 6 个月的
血管紧张素转换酶(ACE)
抑制剂治疗后,其高血压仍未得到控制,他们接受了曲托普利/
维拉帕米(2 毫克/180 毫克,每天一次)的联合治疗。在 6 个月内,每月对患者的坐位血压 (BP)、心率和血浆
葡萄糖进行评估。在使用复方制剂之前和之后的 6 个月中,还进行了 24 小时尿白蛋白和
肌酐清除率检查。结果显示所有患者的血压都有所下降,从平均 168 ± 5/93 ± 3 毫米
汞柱降至 135 ± 4/79 ± 5 毫米
汞柱(p < 0.001),尿白蛋白从 4564.7 ± 563 毫克/天降至 2096.9 ± 296 毫克/天(p < 0.001)。心率和
肌酐清除率没有明显变化。结论对 ACE
抑制剂无反应的 2 型糖尿病患者使用曲托普利/
维拉帕米联合用药可有效降低高血压和白蛋白尿。