Kaaja Risto, Manhem Karin, Tuomilehto Jaakko
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
Int J Clin Pract Suppl. 2004 Mar(139):26-32.
This study compared the effects of two sympatholytic agents--one central (moxonidine) and one peripheral (atenolol)--on blood pressure and other metabolic syndrome factors in postmenopausal hypertensive women who were not taking hormone replacement therapy. Atenolol and moxonidine led to a statistically significant reduction in diastolic blood pressure of 9.5 mmHg and 5.5 mmHg, respectively. A clear rebound effect was observed in the atenolol patients whereas the moxonidine group exhibited a slightly further decrease in blood pressure. Moxonidine also caused a profound decrease in both mean plasma-glucose area under the curve (AUC) during oral glucose tolerance test (-0.96 mmol/L x H, NS) and mean plasma-insulin AUC (-6.15 mU/L x H). Therefore, moxonidine displayed a slightly less potent antihypertensive effect than atenolol in hypertensive postmenopausal women, but it demonstrated a better metabolic effect. To conclude, moxonidine could benefit hypertensive postmenopausal women who display other signs of metabolic syndrome.
本研究比较了两种抗交感神经药——一种是中枢性的(莫索尼定),另一种是外周性的(阿替洛尔)——对未接受激素替代疗法的绝经后高血压女性血压及其他代谢综合征因素的影响。阿替洛尔和莫索尼定分别使舒张压显著降低9.5 mmHg和5.5 mmHg。在阿替洛尔组患者中观察到明显的反跳效应,而莫索尼定组血压则略有进一步下降。莫索尼定还使口服葡萄糖耐量试验期间的平均血浆葡萄糖曲线下面积(AUC)显著降低(-0.96 mmol/L·h,无统计学意义),平均血浆胰岛素AUC也降低(-6.15 mU/L·h)。因此,在绝经后高血压女性中,莫索尼定的降压效果略弱于阿替洛尔,但具有更好的代谢效应。总之,莫索尼定可能对伴有其他代谢综合征体征的绝经后高血压女性有益。