Avorn J, Everitt D E, Weiss S
JAMA. 1986 Jan 17;255(3):357-60.
Little information exists on the epidemiology of central nervous system side effects in patients taking antihypertensive medications. We examined prevalence rates of tricyclic antidepressant (TCA) use among a random sample (N = 143,253) of Medicaid recipients. The TCA use was compared for patients taking any of seven antihypertensive agents and for those prescribed insulin or oral hypoglycemic agents. Use of TCA was significantly higher in patients taking beta-blockers (23% over two years) than for patients taking hydralazine or hypoglycemics (both 15%) or methyldopa or reserpine (both 10%). Prevalence rate ratios revealed a risk of being prescribed a TCA of 1.5 (95% confidence interval, 1.4 to 1.7) for patients receiving beta-blockers relative to patients receiving hydralazine or hypoglycemics. beta-Blocker use may be an important cause of iatrogenic depression among hypertensive patients.
关于服用抗高血压药物患者中枢神经系统副作用的流行病学信息很少。我们在医疗补助受助者的随机样本（N = 143,253）中检查了三环类抗抑郁药（TCA）的使用患病率。比较了服用七种抗高血压药物中的任何一种的患者以及开具胰岛素或口服降糖药的患者的TCA使用情况。服用β受体阻滞剂的患者（两年内为23%）使用TCA的比例显著高于服用肼苯哒嗪或降糖药的患者（均为15%）或甲基多巴或利血平的患者（均为10%）。患病率比显示，相对于服用肼苯哒嗪或降糖药的患者，接受β受体阻滞剂治疗的患者开具TCA的风险为1.5（95%置信区间，1.4至1.7）。使用β受体阻滞剂可能是高血压患者医源性抑郁的一个重要原因。
