Komulainen S, Tähtinen T, Rintamäki H, Virokannas H, Keinänen-Kiukaanniemi S
Department of Public Health Science and General Practice, University of Oulu, Oulun yliopisto, Finland.
Eur J Clin Pharmacol. 2000 Dec;56(9-10):637-42. doi: 10.1007/s002280000208.
The aim of this study was to test the effects of carvedilol on blood pressure (BP) and heart rate (HR) during whole-body cold exposure in hypertensive and normotensive subjects.
Ten hypertensive and twelve normotensive subjects were exposed to cold (-15 degrees C, wind 3.5 m/s) three times for 15 min with a 1-week interval between the exposures. The study design was made according to a randomised double-blind, crossover method. Before the cold exposures the subjects ingested carvedilol or placebo once a day (carvedilol 12.5 mg/day for 2 days and then 25 mg/day for 5 days) for 1 week. The systolic (SBP) and diastolic (DBP) blood pressure and HR were measured every 3 min during the test procedures using an indirect ambulatory blood pressure monitor device (ABPM-02, Meditech Co.).
In the hypertensive group, the cold exposure increased SBP/DBP from 119/75 mmHg to 143/96 mmHg during carvedilol treatment (P<0.001) and from 132/85 mmHg to 159/106 mmHg during placebo (P<0.001). In the normotensive group the cold exposure increased SBP/DBP from 112/72 mmHg to 142/93 mmHg during carvedilol treatment (P<0.001) and from 121/75 mmHg to 147/98 mmHg during placebo (P<0.001). In the hypertensive group, the levels of SBP, DBP and MAP (mean arterial pressure) were significantly lower with carvedilol than with placebo during the cold exposure although carvedilol did not affect the cold-induced rise of the BP. The BPs were lower also with carvedilol in the normotensive group than the placebo during the cold exposure, but the differences were smaller than in the hypertensive group. Carvedilol decreased the BP more the higher the initial mean SBP/DBP was with placebo during the cold exposure.
Carvedilol reduced the BP during the cold exposure, especially in the hypertensive subjects but also in normotensive ones, without effect on the cold-induced rise of the BP.
本研究旨在测试卡维地洛对高血压和血压正常受试者全身冷暴露期间血压（BP）和心率（HR）的影响。
10名高血压受试者和12名血压正常受试者接受三次冷暴露（-15摄氏度，风速3.5米/秒），每次15分钟，暴露间隔为1周。研究设计采用随机双盲交叉法。在冷暴露前，受试者每天服用一次卡维地洛或安慰剂（卡维地洛12.5毫克/天，服用2天，然后25毫克/天，服用5天），持续1周。在测试过程中，使用间接动态血压监测设备（ABPM - 02，美迪泰克公司）每3分钟测量一次收缩压（SBP）、舒张压（DBP）和心率。
在高血压组中，冷暴露期间，服用卡维地洛时收缩压/舒张压从119/75毫米汞柱升至143/96毫米汞柱（P<0.001），服用安慰剂时从132/85毫米汞柱升至159/106毫米汞柱（P<0.001）。在血压正常组中，冷暴露期间，服用卡维地洛时收缩压/舒张压从112/72毫米汞柱升至142/93毫米汞柱（P<0.001），服用安慰剂时从121/75毫米汞柱升至147/98毫米汞柱（P<0.001）。在高血压组中，冷暴露期间，尽管卡维地洛不影响冷诱导的血压升高，但服用卡维地洛时收缩压、舒张压和平均动脉压（MAP）水平显著低于服用安慰剂时。在血压正常组中，冷暴露期间服用卡维地洛时血压也低于服用安慰剂时，但差异小于高血压组。冷暴露期间，初始平均收缩压/舒张压越高，卡维地洛降低血压的幅度越大。
卡维地洛可降低冷暴露期间的血压，尤其是高血压受试者，但血压正常者也有此效果，且对冷诱导的血压升高无影响。
