Schoenberger J A
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Am J Cardiol. 1992 Apr 2;69(10):33C-39C. doi: 10.1016/0002-9149(92)90279-8.
The adverse effects of certain antihypertensive medications, most notably diuretics and beta blockers, on serum lipids, glucose, and potassium may explain why control of hypertension has not been accompanied by declines in coronary artery disease. Evidence indicates that angiotensin-converting enzyme (ACE) inhibitors, including quinapril, the newest member of this class of drugs, have no deleterious effects on these coronary risk factors. In addition to differences in chemical structure, the unique activity of quinapril at the local tissue level might to some degree explain its comparatively favorable clinical profile. Consequently, ACE inhibiting agents may be better choices for the management of patients with mild-to-moderately elevated blood pressure. However, controlled clinical trials with these drugs are needed to determine their impact on events related to coronary artery disease.
某些抗高血压药物，尤其是利尿剂和β受体阻滞剂，对血脂、血糖和钾的不良影响或许可以解释为何控制高血压并未伴随着冠状动脉疾病的减少。有证据表明，包括该类药物的最新成员喹那普利在内的血管紧张素转换酶（ACE）抑制剂，对这些冠心病危险因素并无有害影响。除了化学结构上的差异外，喹那普利在局部组织水平的独特活性可能在一定程度上解释了其相对良好的临床特征。因此，ACE抑制剂可能是治疗轻度至中度血压升高患者的更好选择。然而，需要对这些药物进行对照临床试验，以确定它们对与冠状动脉疾病相关事件的影响。
