Mann S J, Pickering T G, Alderman M H, Laragh J H
Cardiovascular Center, New York Hospital-Cornell Medical Center, New York 10021.
Am J Med. 1989 Jan 23;86(1B):79-81. doi: 10.1016/0002-9343(89)90137-x.
A 24-week, crossover, comparison study was conducted to observe the effects of alpha-blockade with prazosin and beta-blockade with propranolol on blood pressure and plasma lipoprotein levels in 15 hypertensive cigarette smokers. Before treatment, mean sitting blood pressure was 140/100 mm Hg and rose to 147/105 mm Hg after the patients smoked two cigarettes. Treatment with prazosin and propranolol lowered sitting blood pressure to 127/89 mm Hg and 129/91 mm Hg, respectively (not significant), and did not alter the pressor response to smoking. The total cholesterol level at baseline was 207.3 +/- 11.0 mg/dl. This increased to 210.5 +/- 10.2 mg/dl with propranolol treatment and decreased to 201.0 +/- 11.1 mg/dl with prazosin treatment. The low-density lipoprotein cholesterol level was 132.5 +/- 8.1 mg/dl at baseline, 136.9 +/- 8.3 mg/dl with propranolol treatment, and 129.4 +/- 9.0 mg/dl with prazosin treatment (0.05 less than p less than 0.10 between-group comparison). The data indicated that whereas prazosin and propranolol are equally effective in controlling blood pressure in hypertensive cigarette smokers, effects on plasma lipoproteins also may need to be considered when selecting a first-step antihypertensive agent in this coronary-prone population.
进行了一项为期24周的交叉对照研究，以观察哌唑嗪α受体阻滞和普萘洛尔β受体阻滞对15名高血压吸烟者血压和血浆脂蛋白水平的影响。治疗前，平均坐位血压为140/100 mmHg，患者吸两支烟后升至147/105 mmHg。哌唑嗪和普萘洛尔治疗分别将坐位血压降至127/89 mmHg和129/91 mmHg（无显著差异），且未改变对吸烟的升压反应。基线时总胆固醇水平为207.3±11.0 mg/dl。普萘洛尔治疗后升至210.5±10.2 mg/dl，哌唑嗪治疗后降至201.0±11.1 mg/dl。低密度脂蛋白胆固醇水平基线时为132.5±8.1 mg/dl，普萘洛尔治疗后为136.9±8.3 mg/dl，哌唑嗪治疗后为129.4±9.0 mg/dl（组间比较0.05＜p＜0.10）。数据表明，虽然哌唑嗪和普萘洛尔在控制高血压吸烟者血压方面同样有效，但在这个易患冠心病的人群中选择一线抗高血压药物时，也可能需要考虑对血浆脂蛋白的影响。
