Davis B R, Oberman A, Blaufox M D, Wassertheil-Smoller S, Hawkins C M, Cutler J A, Zimbaldi N, Langford H G
Coordinating Center for Clinical Trials, University of Texas School of Public Health, Houston.
Hypertension. 1992 Apr;19(4):393-9. doi: 10.1161/01.hyp.19.4.393.
We report the effect of weight changes of the type of antihypertensive medication prescribed in a trial of the relative efficacy of drug and dietary measures in mild hypertension. The Trial of Antihypertensive Interventions and Management studied 878 mildly hypertensive individuals randomly assigned, in a 3 x 3 design, to no diet change, weight loss, or a low sodium-high potassium diet and to placebo, 25 mg chlorthalidone, or 50 mg atenolol. The type of drug prescribed affected weight change with all diets. The drug effect on weight change, present in all groups at 6 months, was most pronounced in those randomly assigned to the weight loss diet, where the placebo group lost 4.4 kg, the atenolol group lost 3.0 kg, and the chlorthalidone group lost 6.9 kg. The group differences were attenuated but persisted at 24 months. We suggest that the antihypertensive drug prescribed affects the success of a conjoint weight loss program and speculate that the difference between the drugs may be due to their intrinsic effects on the sympathetic nervous system and related metabolic changes.
我们报告了在一项关于药物和饮食措施对轻度高血压相对疗效的试验中，所开抗高血压药物类型的体重变化影响。抗高血压干预与管理试验研究了878名轻度高血压个体，这些个体以3×3设计随机分配到不改变饮食、体重减轻或低钠高钾饮食组，以及安慰剂、25毫克氯噻酮或50毫克阿替洛尔组。所开药物类型影响所有饮食组的体重变化。药物对体重变化的影响在6个月时出现在所有组中，在随机分配到体重减轻饮食组的个体中最为明显，其中安慰剂组体重减轻4.4千克，阿替洛尔组体重减轻3.0千克，氯噻酮组体重减轻6.9千克。组间差异在24个月时有所减弱但仍然存在。我们认为所开的抗高血压药物会影响联合体重减轻计划的成效，并推测药物之间的差异可能归因于它们对交感神经系统的内在作用以及相关的代谢变化。
