St Luke's Roosevelt Hospital Center, Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY 10019, USA.
J Clin Hypertens (Greenwich). 2013 Jun;15(6):435-42. doi: 10.1111/j.1751-7176.2012.00701.x. Epub 2012 Aug 20.
Allopurinol is a potent xanthine oxidase inhibitor that is used in hyperuricemic patients to prevent gout. It has also been shown to decrease cardiovascular complications in a myriad of cardiovascular conditions. However, studies have reported conflicting evidence on its effects on blood pressure (BP). A systematic review was conducted using Medline, PubMed, Embase, and the Cochrane Library for all the longitudinal studies that assessed the efficacy of allopurinol on systolic and diastolic BP. A total of 10 clinical studies with 738 participants were included in the analysis. Compared with the control group, systolic BP decreased by 3.3 mm Hg (95% confidence interval [CI], 1.4-5.3 mm Hg; P=.001) and diastolic BP decreased by 1.3 mm Hg (95% CI, 0.1-2.5 mm Hg; P=.03) in patients treated with allopurinol. When analysis was restricted to the higher-quality randomized controlled trials, similar changes in systolic and diastolic BPs were found: 3.3 mm Hg (95% CI, 0.8-5.8 mm Hg; P<.001) and 1.4 mm Hg (95% CI, 0.1-2.7 mm Hg; P=.04), respectively. Allopurinol is associated with a small but significant reduction in BP. This effect can be potentially exploited to aid in controlling BP in hypertensive patients with hyperuricemia.
别嘌醇是一种强效的黄嘌呤氧化酶抑制剂，用于治疗高尿酸血症患者以预防痛风。它还被证明可以减少多种心血管疾病的心血管并发症。然而，研究报告对其降压作用的证据相互矛盾。使用 Medline、PubMed、Embase 和 Cochrane 图书馆对所有评估别嘌醇对收缩压和舒张压疗效的纵向研究进行了系统评价。共有 10 项临床研究，纳入了 738 名参与者。与对照组相比，别嘌醇治疗组收缩压降低 3.3mmHg（95%置信区间，1.4-5.3mmHg；P=.001），舒张压降低 1.3mmHg（95%置信区间，0.1-2.5mmHg；P=.03）。当分析仅限于高质量的随机对照试验时，发现收缩压和舒张压也有类似的变化：3.3mmHg（95%置信区间，0.8-5.8mmHg；P<.001）和 1.4mmHg（95%置信区间，0.1-2.7mmHg；P=.04）。别嘌醇与血压的微小但显著降低有关。这种效应可能被利用来帮助控制高血压合并高尿酸血症患者的血压。
