Baños Gallardo M, Argüelles Toraño M, Rojo Ortega J M
Rev Clin Esp. 1989 Apr;184(7):347-51.
The possibility that certain antihypertensive drugs produce metabolic alterations in patients with hypertension treated during one year, has been prospectively assessed in 40 patients with essential hypertension with matched age and blood pressure readings. Four groups (Gr) of 10 patients each were studied. Group 1 received 100 mg/day of atenolol (AT), group 2 received 5 mg of amiloride and 50 mg of hydrochlorothiazide (4 tablets per week), group 3 received 40 mg/day of nifedipine retard (NF) and group 4 received 50 mg/day of captopril (CP). The parameters studied prior and after one month of treatment were the following: urea, creatinine, uric acid, Na+, K+, Ca+, total cholesterol, HDL-cholesterol, triglycerides, glycemia, blood pressure (BP), pulse rate (PR) and body weight. Both group 1 and 2 showed significantly increased total cholesterol (p less than 0.001 and p less than 0.01 respectively) as well as decreased HDL levels. In addition, group 2 had significantly increased levels of uric acid, glycemia and triglycerides (p less than 0.01). In the latter groups no significant changes were found within body weight, lipid levels, glycemia, uric acid ruling-out weight gain as a possible cause for these adverse metabolic effects. Pulse rate decreased in group 1. Group 3 pulse rate significantly increased (p less than 0.001) However, no other changes were significant. No significant biochemical or pulse rate readings were found in group 4. BP was best controlled in groups 1, 3 and 4.
对40例年龄和血压匹配的原发性高血压患者进行了前瞻性评估,以研究某些抗高血压药物在治疗一年的高血压患者中产生代谢改变的可能性。将40例患者分为4组,每组10例。第1组患者每天服用100毫克阿替洛尔(AT),第2组患者每天服用5毫克阿米洛利和50毫克氢氯噻嗪(每周4片),第3组患者每天服用40毫克缓释硝苯地平(NF),第4组患者每天服用50毫克卡托普利(CP)。在治疗前和治疗一个月后研究的参数如下:尿素、肌酐、尿酸、钠、钾、钙、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、血糖、血压(BP)、脉搏率(PR)和体重。第1组和第2组的总胆固醇均显著升高(分别为p<0.001和p<0.01),高密度脂蛋白水平降低。此外,第2组的尿酸、血糖和甘油三酯水平显著升高(p<0.01)。在后两组中,体重、血脂水平、血糖、尿酸均无显著变化,排除体重增加是这些不良代谢影响的可能原因。第1组的脉搏率下降。第3组的脉搏率显著升高(p<0.001)。然而,没有其他变化具有显著性。第4组未发现显著的生化或脉搏率变化。第1、3和4组的血压控制最佳。