Trimarco B, Lembo G, DeLuca N, Ricciardelli B, Rosiello G, Volpe M, Orofino G, Condorelli M
First Clinica Medica, Second Faculty of Medicine, University of Naples, Italy.
J Int Med Res. 1988;16 Suppl 1:62A-72A.
The antihypertensive efficacy of a new beta-blocker, celiprolol, was compared with that of a well established antihypertensive drug, metoprolol. Systemic and forearm haemodynamic effects were investigated using echocardiography and two-dimensional pulsed Doppler flowmetry, respectively. Twenty hypertensive patients completed the double-blind crossover randomized study. Each 6-week active treatment period was both preceded and followed by 2 weeks of placebo treatment such that the total duration of the study was 18 weeks. Despite comparable efficacy in reducing systolic and diastolic blood pressures by approximately 10% of the basal value, the two drugs differed in their systemic and haemodynamic effects. Celiprolol significantly decreased forearm peripheral resistance and total peripheral resistance. Cardiac output remained unchanged and forearm blood flow was increased. Metoprolol reduced cardiac output through a reduction in heart rate, but stroke volume was unaltered. Neither drug significantly modified cardiac performance, as evaluated by left ventricular circumferential fibre shortening and left ventricular ejection fraction. Differences in the systemic and regional haemodynamic effects of the two drugs could account for the different blood pressure response seen in some patients. There was no observable change in left ventricular wall thickness or left ventricular mass. These results confirm previous reports which demonstrate that antihypertensive treatment with beta-blockers does not reduce left ventricular mass in patients with a left ventricle of normal size. It is generally accepted, however, that the ability of beta-blockers to reverse left ventricular hypertrophy is unrelated to the individual pharmacological characteristics of each agent.
将一种新型β受体阻滞剂塞利洛尔的降压疗效与一种成熟的降压药物美托洛尔进行了比较。分别使用超声心动图和二维脉冲多普勒血流仪研究了全身和前臂的血流动力学效应。20名高血压患者完成了双盲交叉随机研究。每个为期6周的积极治疗期之前和之后均有2周的安慰剂治疗期，因此研究总时长为18周。尽管在将收缩压和舒张压降低约基础值的10%方面疗效相当，但这两种药物在全身和血流动力学效应方面存在差异。塞利洛尔显著降低了前臂外周阻力和总外周阻力。心输出量保持不变，前臂血流量增加。美托洛尔通过降低心率来降低心输出量，但每搏输出量未改变。通过左心室圆周纤维缩短和左心室射血分数评估，两种药物均未显著改变心脏功能。两种药物在全身和局部血流动力学效应方面的差异可能解释了一些患者出现的不同血压反应。左心室壁厚度或左心室质量没有明显变化。这些结果证实了先前的报道，即β受体阻滞剂降压治疗不会降低左心室大小正常患者的左心室质量。然而，人们普遍认为，β受体阻滞剂逆转左心室肥厚的能力与每种药物的个体药理学特性无关。
