Bouvier J M, Rabot D, Herrero G
Admissions et Urgences, Centre Hospitalier Regional, Angers, France.
J Cardiovasc Pharmacol. 1990;16 Suppl 5:S179-83.
The objective of this study was to compare the efficacy and the safety of bisoprolol (B) and acebutolol (A) on blood pressure at rest and during exercise in hypertensives. The design was a comparative, single-blind study with two phases following a 10-day washout period for pretreated patients: a 15 day-placebo phase and an 8-week therapeutic phase. Forty-six outpatients suffering from mild to moderate essential hypertension [diastolic blood pressure (DBP) ranging between 95 and 120 mm Hg] were randomly given either 10 mg of bisoprolol or 400 mg of acebutolol once a day for 8 weeks; this dosage was doubled after 4 weeks if DBP was still above 90 mm Hg. Blood pressure measurements were made 24 h after drug intake at rest and during exercise stress tests and were performed at the end of the placebo period and after 1 and 2 months of active treatment. Serum lipid levels were also measured before and at the end of the study. Forty-four patients (21 B/23 A) were analyzed for resting blood pressures and 33 (15 B/18 A) for exercise blood pressure profile. At the end of the first month of treatment, a significant decrease (p < 0.001) in supine and upright systolic (SBP) and DBP was noted in both groups. The reduction in supine DBP after 4 weeks was significantly greater with B (p = 0.036). A further decrease of blood pressure was observed in both groups during the second month of treatment, which was significant only in supine SBP (p < 0.05). After 2 months, the heart rate decreased by 24% with B and 13% with A (B vs. A; p = 0.002). Regarding the BP profile during exercise, B and A caused a similar and significant reduction in both SBP and DBP (p < 0.001). The reduction in heart rate during exercise was more marked with B, with no significant difference between the two groups. Side effects were reported in three patients on B and six on A. Both at rest and during exercise, at a level of effort similar to that of daily activities, B exerted a hypotensive effect at least equivalent to that of A in mild and moderate hypertensive patients.
本研究的目的是比较比索洛尔（B）和醋丁洛尔（A）对高血压患者静息及运动时血压的疗效和安全性。研究设计为一项对比性单盲研究，对经过预处理的患者，在10天的洗脱期后分为两个阶段：15天的安慰剂阶段和8周的治疗阶段。46例轻至中度原发性高血压患者[舒张压（DBP）在95至120mmHg之间]被随机给予每天1次10mg比索洛尔或400mg醋丁洛尔，持续8周；如果4周后DBP仍高于90mmHg，则剂量在4周后加倍。在药物摄入24小时后、静息及运动应激试验时测量血压，并在安慰剂期结束时以及积极治疗1个月和2个月后进行测量。在研究开始前及结束时也测量血清脂质水平。对44例患者（21例使用B/23例使用A）分析静息血压，对33例患者（15例使用B/18例使用A）分析运动血压情况。在治疗的第一个月末，两组的仰卧位和直立位收缩压（SBP）及DBP均显著下降（p<0.001）。4周后，B组仰卧位DBP的下降幅度显著更大（p=0.036）。在治疗的第二个月，两组血压进一步下降，仅仰卧位SBP下降显著（p<0.05）。2个月后，B组心率下降24%，A组下降13%（B组与A组比较；p=0.002）。关于运动时的血压情况，B和A对SBP和DBP均产生相似且显著的降低作用（p<0.001）。运动时B组心率下降更明显，两组间无显著差异。报告使用B的3例患者和使用A的6例患者出现副作用。在静息及运动时，在与日常活动相似强度的运动水平下，B对轻、中度高血压患者的降压作用至少与A相当。
