Franz I W, Tönnesmann U, Behr U, Ketelhut R
Klinik Wehrawald der BfA, Todtmoos.
Z Kardiol. 1989;78 Suppl 5:43-8.
In a previous study (1) we could show a significantly more pronounced reversal of LVH with metoprolol than with gallopamil, whereas the combined therapy with atenolol and nifedipine was even more effective. We now report in 121 previously untreated hypertensive patients the longterm effect of the beta-blocker metoprolol (200 mg/die); 25 patients, mean age 43.6 yrs., follow-up 32.1 +/- 3.5 months, group A); the calcium antagonist gallopamil, 26 patients, mean age 49.7 yrs., follow-up 36.2 +/- 2.6 months, group B); the combined therapy with 50 mg atenolol and 20 mg nifedipine, 35 patients, mean age 44.5 yrs., follow-up 31.7 +/- 1.1 months, group C); 200 mg acebutolol and 20 mg nifedipine, mean age 52.1 yrs., follow-up 31.8 +/- 1.8 months, group D); 50 mg atenolol and 10 mg enalapril, mean age 43.3 yrs., follow-up 31.9 +/- 1.3 months, group E). Similar results were obtained for intraventricular septal and posterior wall thickness. Left ventricular enddiastolic dimensions remained unchanged but fractional shortenings were significantly (p less than 0.05-p less than 0.01) increased after 32 months of treatment.
在之前的一项研究(1)中,我们发现美托洛尔使左心室肥厚的逆转比维拉帕米更为显著,而阿替洛尔与硝苯地平联合治疗甚至更有效。我们现在报告121例未经治疗的高血压患者中β受体阻滞剂美托洛尔(200mg/日)的长期疗效;25例患者,平均年龄43.6岁,随访32.1±3.5个月,A组);钙拮抗剂维拉帕米,26例患者,平均年龄49.7岁,随访36.2±2.6个月,B组);50mg阿替洛尔与20mg硝苯地平联合治疗,35例患者,平均年龄44.5岁,随访31.7±1.1个月,C组);200mg醋丁洛尔与20mg硝苯地平,平均年龄为52.1岁,随访31.8±1.8个月,D组);50mg阿替洛尔与10mg依那普利,平均年龄43.3岁,随访31.9±1.3个月,E组)。室间隔和后壁厚度也得到了类似的结果。左心室舒张末期内径保持不变,但治疗32个月后,左心室缩短分数显著增加(p<0.05 - p<0.01)。