Fodor J G, Chockalingam A, Drover A, Fifield F, Pauls C J
Memorial University of Newfoundland, Faculty of Medicine, St. John's, Canada.
J Clin Pharmacol. 1987 Nov;27(11):892-901. doi: 10.1002/j.1552-4604.1987.tb05585.x.
A single-blind study was conducted in 52 hypertensive patients, aged 25 to 68 years, to compare the side effects of an equally effective antihypertensive regimen of propranolol and atenolol. All patients had a history of side effects with beta-blocker therapy. Patients were treated with propranolol 40 to 160 mg bid for 8 weeks, followed by atenolol 50 to 100 mg given once daily for 8 weeks, and then rechallenged with the required dosage of propranolol for 8 weeks. Mean systolic and diastolic blood pressures were controlled during all three treatment phases. Side effects showed a definite trend toward improvement during the atenolol treatment phase. CNS side effects, in particular, showed significantly (P less than .05) reduced severity scores and overall incidence rates during the atenolol treatment phase. In conclusion, this study showed that at equally effective antihypertensive dosages the hydrophilic beta blocker atenolol produced significantly fewer CNS side effects than the lipophilic beta blocker propranolol.
对52名年龄在25至68岁之间的高血压患者进行了一项单盲研究,以比较普萘洛尔和阿替洛尔这两种同等有效的抗高血压方案的副作用。所有患者都有β受体阻滞剂治疗的副作用史。患者先接受8周的普萘洛尔治疗,每日两次,每次40至160毫克,随后接受8周的阿替洛尔治疗,每日一次,每次50至100毫克,然后再接受8周所需剂量的普萘洛尔治疗。在所有三个治疗阶段,平均收缩压和舒张压均得到控制。在阿替洛尔治疗阶段,副作用显示出明显的改善趋势。特别是中枢神经系统副作用,在阿替洛尔治疗阶段,严重程度评分和总体发病率显著降低(P小于0.05)。总之,本研究表明,在同等有效的抗高血压剂量下,亲水性β受体阻滞剂阿替洛尔产生的中枢神经系统副作用明显少于亲脂性β受体阻滞剂普萘洛尔。