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[不同降压药物根据年龄和初始动脉压的疗效]

[Efficacy of various antihypertensive agents according to age and initial arterial pressure].

作者信息

Souviron A, Aguado F

出版信息

Rev Esp Cardiol. 1989 Mar;42(3):177-84.

PMID:2781111
Abstract

210 patients with mild-moderate high blood pressure have been studied. These patients were followed up for 4-6 weeks. Fifty patients were treated with 50 mg hydrochlorothiazide + 5 mg amiloride daily; 40 with 160 mg oxprenolol daily; 22 with 30-40 mg nifedipine daily; 38 with 240 mg verapamil daily and 60 with 50-100 mg captopril daily. We have observed: 1. All treatments have similar antihypertensive effectiveness. 2. Decrement in blood pressure was correlated with initial blood pressure in all treatments, directly. 3. This effectiveness was correlated positively with age in treatment with both diuretics and calcium-antagonists, and an inverse correlation with both beta-blockers and captopril. 4. It had no correlation between age and initial blood pressure in diuretic or beta-blocker treated groups. So diuretics shall be suggested in elderly patients and beta-blockers in younger patients. 5. The greater effectiveness of calcium-antagonists in the elderly should be explained because these patients have a higher initial blood pressure. 6. In this work there is an inverse correlation between age and initial blood pressure in the captopril-treated group; it should explain the greater effectiveness in younger persons. 7. Nothing opposes the use of calcium-antagonists or angiotensin converting enzyme inhibitor in all age groups.

摘要

对210例轻中度高血压患者进行了研究。这些患者随访了4至6周。50例患者每日服用50毫克氢氯噻嗪 + 5毫克阿米洛利;40例患者每日服用160毫克氧烯洛尔;22例患者每日服用30 - 40毫克硝苯地平;38例患者每日服用240毫克维拉帕米;60例患者每日服用50 - 100毫克卡托普利。我们观察到:1. 所有治疗方法的降压效果相似。2. 在所有治疗中,血压下降与初始血压直接相关。3. 在利尿剂和钙拮抗剂治疗中,这种效果与年龄呈正相关,而与β受体阻滞剂和卡托普利呈负相关。4. 在利尿剂或β受体阻滞剂治疗组中,年龄与初始血压之间无相关性。因此,建议老年患者使用利尿剂,年轻患者使用β受体阻滞剂。5. 钙拮抗剂在老年患者中效果更佳,应解释为这些患者初始血压较高。6. 在本研究中,卡托普利治疗组年龄与初始血压呈负相关;这应解释了其在年轻患者中效果更佳的原因。7. 没有任何因素反对在所有年龄组中使用钙拮抗剂或血管紧张素转换酶抑制剂。

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