Niutta E, Cusi D, Colombo R, Tripodi G, Pellizzoni M, Pati P, Cesana B, Alberghini E, Barlassina C, Bianchi G
Istituto di Scienze Mediche, Scuola di Specializzazione in Nefrologia, University of Milano, Italy.
Am J Hypertens. 1988 Oct;1(4 Pt 1):364-71. doi: 10.1093/ajh/1.4.364.
We compared the antihypertensive efficacy of atenolol (100 mg/d), canrenoate potassium (200 mg/d), and captopril (75 mg/d) in 30 essential hypertensives. The three drugs were administered in a randomized change-over sequence for four-months each. The main variables associated with blood pressure regulation were measured in the basal condition and at the end of each treatment period. The erythrocyte Na transport systems were measured only in the basal condition and at the end of the first treatment period. The average blood pressure reduction was similar for each drug. Mean blood pressure levels after captopril correlated positively with those after atenolol in the individual patients (P less than 0.0001); mean blood pressure levels after canrenoate potassium, on the contrary, did not correlate with those after the other two drugs. Captopril and canrenoate potassium treatment reduced intraerythrocyte Na content (P less than 0.02), canrenoate potassium increased Na-K pump (P0.05), atenolol did not change any erythrocyte membrane Na transport parameters. The ouabain-resistant Na transport systems were not modified by any drug. The patients were divided in three groups according to their antihypertensive response: nonresponders (six patients), canrenoate potassium responders (nine patients) and captopril-atenolol responders (15 patients, equally responsive to both drugs). Nonresponders had the lowest basal Na pump (P less than 0.02). Canrenoate potassium responders had higher basal Na-K cotransport than captopril-atenolol responders (P less than 0.02). Atenolol-captopril responders had the highest basal plasma renin activity (PRA, P less than 0.02). The blood pressure reduction after atenolol correlated with the induced fall in PRA (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
我们比较了阿替洛尔（100毫克/天）、坎利酸钾（200毫克/天）和卡托普利（75毫克/天）对30例原发性高血压患者的降压疗效。三种药物按随机交替顺序给药，每种药物给药四个月。在基础状态及每个治疗期结束时测量与血压调节相关的主要变量。仅在基础状态及第一个治疗期结束时测量红细胞钠转运系统。每种药物的平均血压降低情况相似。在个体患者中，卡托普利治疗后的平均血压水平与阿替洛尔治疗后的平均血压水平呈正相关（P<0.0001）；相反，坎利酸钾治疗后的平均血压水平与其他两种药物治疗后的平均血压水平无相关性。卡托普利和坎利酸钾治疗可降低红细胞内钠含量（P<0.02），坎利酸钾可增加钠钾泵活性（P<0.05），阿替洛尔未改变任何红细胞膜钠转运参数。任何药物均未改变哇巴因抵抗性钠转运系统。根据降压反应将患者分为三组：无反应者（6例患者）、坎利酸钾反应者（9例患者）和卡托普利-阿替洛尔反应者（15例患者，对两种药物反应相同）。无反应者的基础钠泵活性最低（P<0.02）。坎利酸钾反应者的基础钠钾协同转运高于卡托普利-阿替洛尔反应者（P<0.02）。卡托普利-阿替洛尔反应者的基础血浆肾素活性（PRA）最高（P<0.02）。阿替洛尔治疗后的血压降低与PRA的下降相关（P<0.001）。（摘要截选至250字）
