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一项辅酶 Q10 治疗代谢综合征合并高血压患者的随机、双盲、安慰剂对照交叉研究。

A randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the metabolic syndrome.

机构信息

Lipid and Diabetes Research Group, Diabetes Research Institute, Christchurch Hospital Campus, New Zealand.

出版信息

Am J Hypertens. 2012 Feb;25(2):261-70. doi: 10.1038/ajh.2011.209. Epub 2011 Nov 24.

Abstract

BACKGROUND

Our aim was to examine the effects of adjunctive coenzyme Q(10) therapy on 24-h ambulatory blood pressure (BP) in subjects with the metabolic syndrome and inadequate BP control.

METHODS

In a randomized, double-blind, placebo-controlled 12-week crossover trial, coenzyme Q(10) (100 mg twice daily) or placebo was administrated to 30 subjects with the metabolic syndrome, and inadequate BP control (an average clinic BP of ≥140 systolic mm Hg or ≥130 mm Hg for patients with type 2 diabetes) while taking an unchanged, conventional antihypertensive regimen. Clinic and 24-h ambulatory BP were assessed pre- and post-treatment phases. The primary outcomes were the changes in 24-h systolic and diastolic BP during adjunctive therapy with coenzyme Q(10) vs. placebo and prespecified secondary outcomes included changes in BP loads.

RESULTS

Compared with placebo, treatment with coenzyme Q(10) was not associated with statistically significant reductions in systolic (P = 0.60) or diastolic 24-h ambulatory BP (P = 0.12) or heart rate (P = 0.10), although daytime diastolic BP loads, were significantly lower during coenzyme Q(10) administration with thresholds set at >90 mm Hg (P = 0.007) and ≥85 mm Hg (P = 0.03). Coenzyme Q(10) was well tolerated and was not associated with any clinically relevant changes in safety parameters.

CONCLUSIONS

Although it is possible that coenzyme Q(10) may improve BP control under some circumstances, any effects are likely to be smaller than reported in previous meta-analyses. Furthermore, our data suggest that coenzyme Q(10) is not currently indicated as adjunctive antihypertensive treatment for patients with the metabolic syndrome whose BP control is inadequate, despite regular antihypertensive therapy.

摘要

背景

我们的目的是研究在代谢综合征和血压控制不理想的患者中,辅酶 Q10(CoQ10)辅助治疗对 24 小时动态血压(ABP)的影响。

方法

在一项随机、双盲、安慰剂对照的 12 周交叉试验中,30 例代谢综合征且血压控制不理想(平均诊室血压≥140 收缩压 mm Hg 或 2 型糖尿病患者≥130 mm Hg)的患者在服用不变的常规降压方案的同时,分别接受辅酶 Q10(每日两次 100 mg)或安慰剂治疗。在治疗前和治疗后阶段评估诊室和 24 小时动态血压。主要终点是辅酶 Q10 辅助治疗与安慰剂相比 24 小时收缩压和舒张压的变化,预设的次要终点包括血压负荷的变化。

结果

与安慰剂相比,辅酶 Q10 治疗与收缩压(P = 0.60)或舒张压(P = 0.12)或心率(P = 0.10)的统计学显著降低无关,但辅酶 Q10 治疗时日间舒张压负荷显著降低,阈值设定为>90 mm Hg(P = 0.007)和≥85 mm Hg(P = 0.03)。辅酶 Q10 耐受良好,与任何安全参数的临床相关变化无关。

结论

尽管辅酶 Q10 在某些情况下可能改善血压控制,但任何效果都可能小于以前的荟萃分析报告的效果。此外,我们的数据表明,尽管有常规的降压治疗,辅酶 Q10 目前不适合作为代谢综合征患者血压控制不理想的辅助降压治疗。

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