Traub Y M
Department of Internal Medicine A, Rebecca Sieff Medical Center, Safed, Israel.
Arch Intern Med. 1988 Jan;148(1):77-80.
Direct within-patient comparisons of the effects of centrally acting sympathetic inhibitors and beta-blockers on blood pressure (BP) of the elderly have not been done. In the present study, 32 elderly hypertensive patients were treated with a diuretic. Methyldopa (500 mg/d) (16 patients, subgroup A) or slow-release oxprenolol (80 mg/d) (subgroup B) was added as a second-step antihypertensive agent for a period of eight weeks, after which the second-step agents were switched, respectively, for another period of eight weeks. In subgroup A the supine BP dropped from 193/99 to 169/93 mm Hg and the standing BP from 183/100 to 163/92 mm Hg, whereas in subgroup B the supine BP fell from 190/103 to 182/97 mm Hg and the standing BP from 187/101 to 172/95 mm Hg. After switching the drugs, the respective BP values were 177/91 and 170/95 mm Hg and 170/90 and 156/89 mm Hg. In the doses given, methyldopa therapy is more effective than oxprenolol therapy in lowering the BP of elderly hypertensive patients.
尚未对中枢作用交感神经抑制剂和β受体阻滞剂对老年人血压（BP）的影响进行直接的患者内比较。在本研究中，32例老年高血压患者接受了利尿剂治疗。作为第二步抗高血压药物，分别给16例患者（A亚组）加用甲基多巴（500mg/d）或给另一组患者（B亚组）加用缓释氧烯洛尔（80mg/d），为期8周，之后分别更换第二步用药，再持续8周。在A亚组中，仰卧位血压从193/99mmHg降至169/93mmHg，站立位血压从183/100mmHg降至163/92mmHg；而在B亚组中，仰卧位血压从190/103mmHg降至182/97mmHg，站立位血压从187/101mmHg降至172/95mmHg。换药后，各自的血压值分别为177/91和170/95mmHg以及170/90和156/89mmHg。在给定剂量下，甲基多巴治疗在降低老年高血压患者血压方面比氧烯洛尔治疗更有效。
