Mores N, Campia U, Navarra P, Cardillo C, Preziosi P
Istituto di Farmacologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Eur J Clin Pharmacol. 1999 Jun;55(4):251-4. doi: 10.1007/s002280050624.
The use of the decongestant pseudoephedrine has been cautioned in patients with arterial hypertension, due to the possible rise in blood pressure induced by the sympathostimulatory properties of the drug. This effect could be enhanced in hypertensives treated with beta-blockers, in whom the vasoconstrictor effect of alpha-adrenergic stimulation is unbalanced. The purpose of this study was to investigate the cardiovascular response to pseudoephedrine in hypertensive patients treated with different types of beta-blockers.
We recruited 29 (18 males) mild-to-moderate essential hypertensive patients [mean age 49(2) years] in a randomized, placebo-controlled, crossover trial. All participants received either placebo, or a nonselective (propranolol 160 mg once daily) or a selective (atenolol 100 mg once daily) beta-blocker for 1 week. At the end of each period, all patients received a single oral dose of pseudoephedrine (60 mg) and their blood pressure and heart rate were monitored at repeated intervals for 2 h.
After 1 week of propranolol or atenolol, patients had significantly lower systolic blood pressure and heart rate than after placebo, whereas diastolic blood pressure was not significantly modified. The acute administration of pseudoephedrine did not change systolic and diastolic blood pressure and heart rate from baseline at the end of any of the treatment periods.
A standard oral dose of pseudoephedrine does not significantly affect blood pressure values in hypertensive patients treated with beta-blockers, and therefore may be safely used in this subset of patients.
由于减充血剂伪麻黄碱具有交感神经兴奋特性，可能导致血压升高，因此已对动脉高血压患者使用该药提出警示。在用β受体阻滞剂治疗的高血压患者中，这种效应可能会增强，因为在这些患者中α-肾上腺素能刺激的血管收缩效应失衡。本研究的目的是调查使用不同类型β受体阻滞剂治疗的高血压患者对伪麻黄碱的心血管反应。
我们招募了29名（18名男性）轻度至中度原发性高血压患者[平均年龄49（2）岁]，进行一项随机、安慰剂对照、交叉试验。所有参与者接受安慰剂、非选择性（普萘洛尔160mg，每日一次）或选择性（阿替洛尔100mg，每日一次）β受体阻滞剂治疗1周。在每个治疗期结束时，所有患者口服单剂量伪麻黄碱（60mg），并在2小时内重复监测其血压和心率。
服用普萘洛尔或阿替洛尔1周后，患者的收缩压和心率显著低于服用安慰剂后，而舒张压无显著变化。在任何治疗期结束时，急性给予伪麻黄碱后，收缩压、舒张压和心率与基线相比均无变化。
标准口服剂量的伪麻黄碱对用β受体阻滞剂治疗的高血压患者的血压值无显著影响，因此可在这类患者中安全使用。
