Richardson P J, Wyke M A
Department of Cardiology, King's College Hospital, London.
Drugs. 1988;35 Suppl 5:80-5. doi: 10.2165/00003495-198800355-00014.
Improvement in the efficacy of newer antihypertensive agents has resulted in consideration of the side effects of drug therapy. Impairment of memory function resulting from antihypertensive therapy has been clinically suspected. This observation has been supported by a study in which the effects of methyldopa and propranolol on memory function were reported. Recently, memory function has been assessed in a group of patients treated with either a beta-blocker (atenolol) or an angiotensin-converting enzyme inhibitor (enalapril) in a randomised, observer-blind study in moderate essential hypertension. The patients were assessed, on placebo and after 16 weeks of treatment on active therapy, by use of a series of 4 memory function tests related to everyday life. In the hypertension study group, 13 received atenolol and 12 received enalapril. Similar reduction of diastolic pressure occurred in both groups, but systolic pressure was significantly reduced in the enalapril group (p less than 0.05). In the atenolol group memory performance scores were consistently lower than in the placebo phase in 9 of 28 estimates of memory function. In the enalapril group there were no significant changes. The study indicated that atenolol might produce mild memory impairment, whereas enalapril was devoid of any measurable effect on memory function.
新型抗高血压药物疗效的提高促使人们考虑药物治疗的副作用。临床上怀疑抗高血压治疗会导致记忆功能受损。一项报告甲基多巴和普萘洛尔对记忆功能影响的研究支持了这一观察结果。最近,在一项针对中度原发性高血压患者的随机、观察者盲法研究中,对一组接受β受体阻滞剂(阿替洛尔)或血管紧张素转换酶抑制剂(依那普利)治疗的患者的记忆功能进行了评估。在服用安慰剂时以及接受积极治疗16周后,通过一系列与日常生活相关的4项记忆功能测试对患者进行评估。在高血压研究组中,13人接受阿替洛尔治疗,12人接受依那普利治疗。两组舒张压均有类似程度的降低,但依那普利组收缩压显著降低(p<0.05)。在阿替洛尔组中,28项记忆功能评估中有9项的记忆表现得分始终低于安慰剂阶段。在依那普利组中则没有显著变化。该研究表明,阿替洛尔可能会产生轻度记忆损害,而依那普利对记忆功能没有任何可测量的影响。