Ramirez E A, Elson L, Gear A S, Oster J R, Talmers F N, Thomas J R
Circulation. 1977 Mar;55(3):519-25. doi: 10.1161/01.cir.55.3.519.
One hundred and eight patients with initial diastolic blood pressure in the range of 100-124 mm Hg while taking hydrochlorothiazide were assigned randomly and double-blind to hydrochlorothiazide plus either bethanidine or guanethidine. The average reduction of the fifth and sixth months' diastolic blood pressure was 18.4 mm Hg for guanethidine and 13.6 mm Hg for bethanidine (P less than 0.01). The distribution of the individual values was such that 68.8% of guanethidine treated patients achieved a diastolic level below 90 mm Hg, compared to only 45.5% of the bethanidine treated group (P less than 0.025). The degree of orthostatic fall in blood pressure was greater with bethanidine than with guanethidine (P less than 0.05). The diurnal variation of blood pressure was slightly greater with bethanidine than with guanethidine. The results significantly favor guanethidine. This study failed to demonstrate that the shorter action of bethanidine confers significantly better control of blood pressure than the longer action of guanethidine.
108名正在服用氢氯噻嗪且初始舒张压在100 - 124毫米汞柱之间的患者被随机双盲分配至氢氯噻嗪加苄乙胍或胍乙啶组。胍乙啶治疗组在第五和第六个月时舒张压平均降低18.4毫米汞柱，苄乙胍治疗组为13.6毫米汞柱（P < 0.01）。个体值分布情况为，胍乙啶治疗组68.8%的患者舒张压降至90毫米汞柱以下，而苄乙胍治疗组仅有45.5%达到此水平（P < 0.025）。苄乙胍导致的体位性血压下降程度大于胍乙啶（P < 0.05）。苄乙胍引起的血压昼夜变化略大于胍乙啶。结果明显支持胍乙啶。本研究未能证明苄乙胍作用时间较短在血压控制方面比胍乙啶作用时间较长有显著优势。
