Mace P J, Littler W A, Glover D R, Rowlands D B, Stallard T J
J Cardiovasc Pharmacol. 1985;7 Suppl 2:S52-5. doi: 10.1097/00005344-198507002-00011.
We examined the effect of three antihypertensive agents with differing modes of action on blood pressure, heart rate, plasma catecholamines, plasma renin activity, and echocardiographic left ventricular mass. Twenty-six patients were studied; nine were treated with nifedipine, a calcium antagonist, nine were treated with timolol, a nonselective beta-blocker, and eight were treated with indapamide, a diuretic with some probable calcium antagonist properties. All drugs reduced blood pressure satisfactorily; the reduction of systolic blood pressure was not significantly different among the three drugs, but timolol reduced diastolic blood pressure by a greater amount than did either indapamide or nifedipine. Left ventricular (LV) mass was reduced equally by all three drugs. However, there were markedly different effects on the other parameters measured. Heart rate was reduced to a greater extent by timolol than by the other two drugs. Plasma renin activity was reduced by timolol, unchanged by nifedipine, and increased by indapamide. There were no significant changes in either adrenaline or noradrenaline with any of the three drugs. We conclude that these data do not support the hypothesis that the sympathetic nervous system is primarily responsible for left ventricular hypertrophy, and suggest that reduction of left ventricular mass with antihypertensive agents is not the property of any one class of drug.
我们研究了三种作用方式不同的抗高血压药物对血压、心率、血浆儿茶酚胺、血浆肾素活性及超声心动图测定的左心室质量的影响。共研究了26例患者；9例接受钙拮抗剂硝苯地平治疗，9例接受非选择性β受体阻滞剂噻吗洛尔治疗，8例接受具有一定钙拮抗剂特性的利尿剂吲达帕胺治疗。所有药物均能令人满意地降低血压；三种药物降低收缩压的效果无显著差异，但噻吗洛尔降低舒张压的幅度大于吲达帕胺或硝苯地平。三种药物均能同等程度地减轻左心室（LV）质量。然而，对所测的其他参数有明显不同的影响。噻吗洛尔降低心率的程度大于其他两种药物。噻吗洛尔降低血浆肾素活性，硝苯地平使其无变化，吲达帕胺则使其升高。三种药物中的任何一种对肾上腺素或去甲肾上腺素均无显著影响。我们得出结论，这些数据不支持交感神经系统是左心室肥厚主要原因的假说，并表明用抗高血压药物减轻左心室质量并非某一类药物所特有的作用。
