Escobar-Jiminez F, Fernandez Soto M L, Lobon J A, Aguilar M, Campos-Pastor M M, Garcia del Rio C
Endocrine Unit, Hospital Clinico San Cecilio, Granada University, Spain.
Postgrad Med J. 1988;64 Suppl 3:65-8; discussion 90-2.
Thirty patients (21 F, 9 M) of mean age 55.3 years with non-insulin dependent diabetes mellitus of mean duration 10.8 years and hypertension (blood pressure 160/95 mm Hg) of 0.3 to 4.0 years were randomly allocated to either a twice daily regimen of captopril (50 mg twice daily, Group A) or a once daily captopril schedule (50 mg once daily, Group B). Good glycaemic control (HbA1c, mean 7.63%) had been achieved with sulphonylureas in 22 patients and insulin in 8 patients. There were no statistical differences in baseline values between the two groups. For the 15 patients in Group A, blood pressure fell significantly from a baseline of 177 +/- 13.2/106 +/- 7.8 mm Hg to 161 +/- 14.3/91 +/- 6.9 after one month (P less than 0.05) and continued to decrease at 3 and 6 months. In Group B the blood pressure changed from 179 +/- 19.0/110 +/- 15.6 to 169 +/- 21.0/98 +/- 7.2 at 1 month (P less than 0.05) with further reductions again seen at 3 and 6 months. Nine patients had poorer response than the other 21 but there were no demographic differences between these subgroups nor were there any differences in plasma renin activity or aldosterone responses. There were no statistically significant changes in haematological or biochemical values in either group during treatment. In particular, HbA1c and fasting glucose were unaffected by captopril treatment. No side effects were encountered during the 6 months of follow-up. In conclusion, captopril is an effective antihypertensive in non-insulin dependent diabetes mellitus with mild to moderate hypertension and a once daily regimen could improve compliance.
30例患者（21例女性，9例男性），平均年龄55.3岁，患有平均病程10.8年的非胰岛素依赖型糖尿病以及病程0.3至4.0年的高血压（血压160/95 mmHg），被随机分为两组，一组接受卡托普利每日两次给药方案（每日50 mg，分两次服用，A组），另一组接受卡托普利每日一次给药方案（每日50 mg，一次服用，B组）。22例患者通过磺脲类药物、8例患者通过胰岛素实现了良好的血糖控制（糖化血红蛋白，平均7.63%）。两组的基线值无统计学差异。A组的15例患者，血压从基线的177±13.2/106±7.8 mmHg显著降至1个月后的161±14.3/91±6.9 mmHg（P<0.05），并在3个月和6个月时持续下降。B组血压在1个月时从179±19.0/110±15.6变为169±21.0/98±7.2（P<0.05），在3个月和6个月时也再次出现进一步下降。9例患者的反应比其他21例患者差，但这些亚组之间在人口统计学方面无差异，血浆肾素活性或醛固酮反应也无差异。治疗期间两组的血液学或生化值均无统计学意义上的显著变化。特别是，糖化血红蛋白和空腹血糖不受卡托普利治疗的影响。在6个月的随访期间未出现副作用。总之，卡托普利对伴有轻至中度高血压的非胰岛素依赖型糖尿病是一种有效的降压药物，每日一次给药方案可提高依从性。
