Hunyor S N, Zweifler A J, Hansson L, Schork M A, Ellis C
Aust N Z J Med. 1975 Feb;5(1):17-24. doi: 10.1111/j.1445-5994.1975.tb03249.x.
The effect on blood pressure of high (400 mg/day-S400) and moderate dose (200 mg/day-S200) spironolactone and chlorthalidone (100 mg/day-C100), given in a random double-blind manner was related to plasma renin activity and plasma volume in 38 essential hypertensives. The fall in pressure from a control of 154/103 mm Hg was essentially the same after four weeks of each drug--S400 deltaBP 24/13 mm, S200 18/9 mm, C100 17/12 mm (all P less than 0-001). Twelve of 37 patients (32%) had low initial renin, but this appeared as responsive to the chlorthalidone stimulus as that of the normal renin group. The antihypertensive effect of all regimens was unrelated to plasma renin activity. Plasma volume was significantly lowered at the end of each treatment period, but the decline could not be correlated with blood pressure effects. Patients with initially low plasma volume were more likely to respond to S400 (r = 0-545, P less than 0-001), whereas the antihypertensive effect of the S200 and C100 regimens was independent of this variable.
以随机双盲方式给予38例原发性高血压患者高剂量（400毫克/天-S400）和中等剂量（200毫克/天-S200）的螺内酯以及氢氯噻嗪（100毫克/天-C100），观察其对血压的影响，并分析其与血浆肾素活性和血浆容量的关系。每种药物治疗四周后，血压从初始的154/103毫米汞柱下降幅度基本相同——S400血压下降24/13毫米，S200下降18/9毫米，C100下降17/12毫米（P均小于0.001）。37例患者中有12例（32%）初始肾素水平较低，但他们对氢氯噻嗪刺激的反应与正常肾素组相似。所有治疗方案的降压效果均与血浆肾素活性无关。在每个治疗期末，血浆容量均显著降低，但这种下降与血压变化无关。初始血浆容量较低的患者对S400更可能有反应（r = 0.545，P小于0.001），而S200和C100治疗方案的降压效果与该变量无关。
