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特他洛尔治疗高血压。对2338例患者的长期治疗

Tertatolol in hypertension. Long-term therapy in 2,338 patients.

作者信息

Guery O, Herpin D, Lecasble M, Piron J

机构信息

Institut de Recherches Internationales Servier, Neuilly-sur-Seine, France.

出版信息

Am J Hypertens. 1989 Nov;2(11 Pt 2):289S-295S. doi: 10.1093/ajh/2.11.289s.

Abstract

Tertatolol has been studied in 2,338 patients with mild to moderate hypertension over a one year period. Tertatolol (T) was initiated alone (5 mg once daily) and if satisfactory control of blood pressure (BP) (diastolic BP less than 95 mm Hg) was not achieved, treatment was adapted at the third or sixth month either by increasing the dosage (heart rate greater than 70 beats/min), or by adding a potassium-sparing diuretic (heart rate less than or equal to 70 beats/min). Blood pressure normalization was achieved in 88.8% of the study population: 66.1% on single and 22.7% on dual therapy. The decrease of diastolic BP was 18.4 mm Hg (from 102.8 +/- 0.2 to 84.4 +/- 0.2 mm Hg, P less than .001). Tertatolol alone or associated with diuretic (T + D) induced a significant and continuous decrease in supine systolic and diastolic BP. Overall side effects were rare, leading in only 6.5% of the cases to the discontinuation of the drug. Plasma creatinine significantly decreased in the single therapy group only (from 92.2 +/- 0.5 to 90.1 +/- 0.5 mumol/L, P less than .01). In patients with initial plasma creatinine greater than or equal to 100 mumol/L (n = 661), plasma creatinine markedly decreased (-10%, from 114.6 +/- 0.7 to 103.4 +/- 0.8 mumol/L, P less than .01), and to the same extent with T or T + D. Thus, this large-scale study confirms that tertatolol is an efficient and well-tolerated antihypertensive drug, which improves renal function, especially when initially reduced.

摘要

在一年时间里,对2338例轻至中度高血压患者进行了心得怡的研究。开始单独使用心得怡(每日1次,5毫克),如果血压(BP)未得到满意控制(舒张压低于95毫米汞柱),则在第三个月或第六个月调整治疗方案,方法是增加剂量(心率大于70次/分钟),或者加用保钾利尿剂(心率小于或等于70次/分钟)。88.8%的研究人群实现了血压正常化:单药治疗组为66.1%,联合治疗组为22.7%。舒张压下降了18.4毫米汞柱(从102.8±0.2降至84.4±0.2毫米汞柱,P<0.001)。单独使用心得怡或与利尿剂联合使用(心得怡+利尿剂)可使仰卧位收缩压和舒张压显著持续下降。总体副作用很少见,仅6.5%的病例因副作用停药。仅在单药治疗组中,血浆肌酐显著下降(从92.2±0.5降至90.1±0.5微摩尔/升,P<0.01)。在初始血浆肌酐大于或等于100微摩尔/升的患者中(n=661),血浆肌酐显著下降(-10%,从114.6±0.7降至103.4±0.8微摩尔/升,P<0.01),心得怡单独使用或与利尿剂联合使用时下降幅度相同。因此,这项大规模研究证实,心得怡是一种有效且耐受性良好的降压药物,可改善肾功能,尤其是在肾功能最初降低时。

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