Leonetti G, Rappelli A, Salvetti A, Scapellato L
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
Am J Med. 1988 Jan 29;84(1B):59-64.
Since hypertension is an important risk factor of cardiovascular morbidity and mortality that can be at least in part decreased by pharmacologic reduction in elevated blood pressure, it is necessary that an antihypertensive agent be effective, but at the same time well tolerated and, according to some recent hypotheses, have no deleterious effect on serum electrolyte levels, as well as lipoprotein and glucose tolerance. However, due to different cultural and social backgrounds, lifestyles, and so on, the tolerability may differ from one population to another and the conclusions drawn from a population cannot be extrapolated to people of other countries. For these reasons, the well-being of patients, as well as the tolerability of indapamide, a non-thiazide diuretic, have been investigated in patients with hypertension of mild and moderate degree from different parts of Italy with a satisfactory blood-pressure response to this drug (-22.8 +/- 0.6/-17.1 +/- 0.5 mm Hg). Simultaneous to the significant blood-pressure reduction, the only significant change among the metabolic effects was a slight reduction in plasma potassium levels (-0.37 +/- 0.03 meq/liter). The tolerability was, on the whole, very good with a tendency toward an improvement of well-being in patients, the majority of whom were already asymptomatic before starting the treatment.
由于高血压是心血管发病和死亡的重要危险因素，通过药物降低血压升高至少可以部分降低该风险，因此抗高血压药物必须有效，但同时耐受性良好，并且根据一些最新假说，对血清电解质水平以及脂蛋白和糖耐量无有害影响。然而，由于不同的文化和社会背景、生活方式等因素，不同人群的耐受性可能存在差异，从某一人群得出的结论不能外推至其他国家的人群。基于这些原因，在意大利不同地区轻度和中度高血压患者中对吲达帕胺（一种非噻嗪类利尿剂）的患者健康状况及耐受性进行了研究，这些患者对该药物有令人满意的血压反应（-22.8±0.6/-17.1±0.5 mmHg）。在血压显著降低的同时，代谢效应中唯一显著的变化是血浆钾水平略有降低（-0.37±0.03 meq/升）。总体而言，耐受性非常好，患者的健康状况有改善的趋势，其中大多数患者在开始治疗前已经无症状。
