Leren P
Clin Ther. 1987;9(3):326-32.
Despite the well-established correlation between coronary heart disease (CHD) and hypertension, conventional antihypertensive therapy with diuretics and beta-adrenergic blockers has failed to provide protection against CHD. A possible explanation for this failure is the unfavorable effect such drugs have on lipid metabolism. To compare the lipid profiles of commonly used antihypertensive drugs, a survey was made of selected studies from the literature. Diuretics and selective and nonselective beta-blockers were found to have adverse effects on blood lipids. Beta-blockers with intrinsic sympathomimetic activity, labetalol, methyldopa, and calcium channel blockers are lipid neutral, whereas alpha-adrenergic blockers seemed to have a favorable effect on lipid metabolism. Controlled clinical trials with drugs that have no adverse effects on lipid metabolism are needed to establish the long-term clinical importance of such agents.
尽管冠心病（CHD）与高血压之间的关联已得到充分证实，但使用利尿剂和β-肾上腺素能阻滞剂的传统抗高血压治疗未能提供针对冠心病的保护作用。这种失败的一个可能解释是此类药物对脂质代谢有不利影响。为比较常用抗高血压药物的脂质谱，对文献中选定的研究进行了一项调查。发现利尿剂以及选择性和非选择性β受体阻滞剂对血脂有不良影响。具有内在拟交感神经活性的β受体阻滞剂、拉贝洛尔、甲基多巴和钙通道阻滞剂对脂质无影响，而α-肾上腺素能阻滞剂似乎对脂质代谢有有利影响。需要使用对脂质代谢无不利影响的药物进行对照临床试验，以确定此类药物的长期临床重要性。
