Leren P, Helgeland A
Drugs. 1986;31 Suppl 1:41-5. doi: 10.2165/00003495-198600311-00008.
The Oslo Hypertension Study started in 1972 and lasted for 66 (range 60-78) months. A total of 785 healthy men, aged 40 to 49 years, with mild hypertension were randomised to a drug-treated group and to an untreated, control group. The drugs used for treatment were hydrochlorothiazide alone in 36%, hydrochlorothiazide and propranolol in 26%, hydrochlorothiazide and methyldopa in 20%, and other drugs in 18%. A total of 95% in the drug-treated group received hydrochlorothiazide. Pressure complications, such as stroke and aneurysms, only occurred in the control group. Coronary events were more numerous in the drug-treated group, so that the total incidence of cardiovascular complications did not significantly differ between the treated and untreated groups. After 5 and 10 years, total mortality was found to be the same in both groups. However, the 10-year coronary heart disease mortality was significantly higher in the drug-treated group than in the untreated controls (14 v 3, p less than 0.01). Possible reasons for the failing effect of drug treatment of hypertension on coronary heart disease is discussed, and attention is drawn to the adverse effect of diuretics and beta-adrenergic blockers, both on lipid and carbohydrate metabolism. This is in contrast to the alpha-adrenergic blocker, prazosin, which has been shown to improve the blood lipid profile.
奥斯陆高血压研究始于1972年，持续了66个月（范围为60 - 78个月）。共有785名年龄在40至49岁之间的轻度高血压健康男性被随机分为药物治疗组和未治疗的对照组。治疗所用药物中，仅使用氢氯噻嗪的占36%，氢氯噻嗪和普萘洛尔的占26%，氢氯噻嗪和甲基多巴的占20%，其他药物的占18%。药物治疗组中共有95%的人接受了氢氯噻嗪治疗。诸如中风和动脉瘤等血压并发症仅发生在对照组。药物治疗组的冠心病事件更多，因此治疗组和未治疗组之间心血管并发症的总发生率没有显著差异。5年和10年后，发现两组的总死亡率相同。然而，药物治疗组的10年冠心病死亡率显著高于未治疗的对照组（14比3，p小于0.01）。文中讨论了高血压药物治疗对冠心病效果不佳的可能原因，并提请注意利尿剂和β - 肾上腺素能阻滞剂对脂质和碳水化合物代谢的不良影响。这与α - 肾上腺素能阻滞剂哌唑嗪形成对比，哌唑嗪已被证明可改善血脂状况。
