Holtzman J L, Kaihlanen P M, Rider J A, Lewin A J, Spindler J S, Oberlin J A
Veterans Administration Medical Center, Minneapolis, MN 55417.
Arch Intern Med. 1988 Mar;148(3):539-43.
The safety and efficacy of once-daily terazosin hydrochloride administered concomitantly with once-daily atenolol for the treatment of essential hypertension were evaluated in this double-blind, multiclinic, placebo-controlled study. After each patient received 50 mg of atenolol daily for eight weeks, patients with a supine diastolic blood pressure (DBP) of 95 to 110 mm Hg and whose supine DBP had decreased at least 5 mm Hg were randomized to receive either terazosin (plus atenolol) or placebo (plus atenolol) for ten weeks. Patients assigned to the terazosin hydrochloride treatment group received increasing dosages (1,2,5, and 10 mg daily) [corrected] of terazosin at two-week intervals until the maximum dose was reached or until the supine DBP was decreased to less than 90 mm Hg. Terazosin-treated patients (n = 43) had significant mean decreases from the baseline in supine BP (systolic/diastolic = -8.8/-8.5 mm Hg) and standing BP (-10.9/-9.5 mm Hg), whereas the decreases in BP in the placebo-treated patients (n = 49; supine, -2.3/-2.6 mm Hg; standing, -1.4/-1.3 mm Hg) were not significant. When terazosin and placebo were compared, the differences in BP were significant. Terazosin-treated patients had significantly greater decreases in mean percent change of total cholesterol (-4.8%) and low-density lipoprotein plus very-low-density lipoprotein cholesterol (-6.3%) levels, compared with the placebo-treated patients (+0.6% and +1.1%, respectively). Concomitant administration of terazosin and atenolol to patients with essential hypertension was found to be safe and efficacious.
在这项双盲、多中心、安慰剂对照研究中,评估了每日一次的盐酸特拉唑嗪与每日一次的阿替洛尔联合使用治疗原发性高血压的安全性和有效性。在每位患者每日服用50 mg阿替洛尔八周后,将仰卧位舒张压(DBP)为95至110 mmHg且仰卧位DBP至少降低5 mmHg的患者随机分为接受特拉唑嗪(加阿替洛尔)或安慰剂(加阿替洛尔)治疗十周。分配到盐酸特拉唑嗪治疗组的患者每隔两周递增剂量(每日1、2、5和10 mg)[校正后]服用特拉唑嗪,直至达到最大剂量或仰卧位DBP降至90 mmHg以下。接受特拉唑嗪治疗的患者(n = 43)仰卧位血压(收缩压/舒张压=-8.8/-8.5 mmHg)和站立位血压(-10.9/-9.5 mmHg)较基线均有显著下降,而接受安慰剂治疗的患者(n = 49;仰卧位,-2.3/-2.6 mmHg;站立位,-1.4/-1.3 mmHg)血压下降不显著。比较特拉唑嗪和安慰剂时,血压差异显著。与接受安慰剂治疗的患者(分别为+0.6%和+1.1%)相比,接受特拉唑嗪治疗的患者总胆固醇平均变化百分比(-4.8%)和低密度脂蛋白加极低密度脂蛋白胆固醇平均变化百分比(-6.3%)下降幅度更大。结果发现,原发性高血压患者联合使用特拉唑嗪和阿替洛尔是安全有效的。