Kujala S M, Pöyhönen-Alho M, Kaaja R J
University of Helsinki, Faculty of Pharmacy, Industrial Pharmacy , Helsinki.
Climacteric. 2014 Aug;17(4):356-62. doi: 10.3109/13697137.2013.842226. Epub 2013 Nov 8.
The short-term effects of two sympatholytic antihypertensive drug treatments, β-blocking agent atenolol and imidazoline receptor-1 agonist moxonidine, on postmenopausal symptoms and their relationship to antihypertensive and insulin sensitivity effect were studied.
This was a double-blind, prospectively randomized study in a multicenter, multinational setting in 112 hypertensive, overweight, postmenopausal women without hormone therapy.
Treatment was either with moxonidine, 0.6 mg/day, or with atenolol, 50 mg/day, for 8 weeks. The main outcome measures were blood pressure, insulin sensitivity by Matsuda sensitivity index and postmenopausal symptoms (hot flushes, palpitations, insomnia, irritability, depression and general impression of the symptoms (GIS) through a questionnaire.
Both atenolol and moxonidine caused a significant reduction in diastolic blood pressure of 9.5 mmHg and 6.2 mmHg, respectively. The severity of hot flushes and palpitations were reduced significantly in both treatment groups. Relief from hot flushes was recorded in 43% of women taking atenolol and in 27% (not significant between the groups) of moxonidine-treated patients. Palpitations were relieved in 41% and 25% (not significant between the groups) of the women in the atenolol- and moxonidine-treated groups, respectively. In the atenolol group, insomnia and GIS were reduced significantly, with relief of symptoms occurring in 33% and 27% of the patients. A change in irritability was seen in blood pressure responders during the treatment in the atenolol group. There was no correlation between improvement of insulin sensitivity and relief of postmenopausal symptoms.
In this study, two sympatholytic antihypertensives, atenolol and moxonidine, provided relief from hot flushes and palpitations, and atenolol additionally helped with insomnia and improved GIS.
研究两种抗交感神经降压药物治疗（β受体阻滞剂阿替洛尔和咪唑啉受体-1激动剂莫索尼定）对绝经后症状的短期影响及其与降压和胰岛素敏感性作用的关系。
这是一项在多中心、跨国环境中针对112名未接受激素治疗的高血压、超重绝经后女性进行的双盲、前瞻性随机研究。
治疗方案为每天服用0.6毫克莫索尼定或50毫克阿替洛尔，为期8周。主要观察指标为血压、通过松田敏感性指数评估的胰岛素敏感性以及绝经后症状（潮热、心悸、失眠、易怒、抑郁），并通过问卷调查了解症状总体印象（GIS）。
阿替洛尔和莫索尼定分别使舒张压显著降低9.5毫米汞柱和6.2毫米汞柱。两个治疗组的潮热和心悸严重程度均显著降低。服用阿替洛尔的女性中有43%潮热症状得到缓解，服用莫索尼定的患者中有27%（两组间无显著差异）。阿替洛尔治疗组和莫索尼定治疗组分别有41%和25%的女性心悸症状得到缓解（两组间无显著差异）。在阿替洛尔组，失眠和GIS显著降低，分别有33%和27%的患者症状得到缓解。在阿替洛尔组治疗期间，血压有反应者的易怒情绪有所变化。胰岛素敏感性的改善与绝经后症状的缓解之间无相关性。
在本研究中，两种抗交感神经降压药阿替洛尔和莫索尼定可缓解潮热和心悸，阿替洛尔还可改善失眠并提高GIS。
