Dollery C T
Department of Pharmacology, Royal Postgraduate Medical School, London, UK.
J Hypertens Suppl. 1987 Aug;5(3):S75-8.
The principal results of the Medical Research Council (MRC) Hypertension Trial were published in mid-1985 and additional papers are in preparation which will give more detailed information about important issues such as the influence of treatment upon ischaemic heart disease. This paper briefly reviews some points about the trial. The main results of the MRC trial were that stroke was reduced on average by about half (69% with bendrofluazide, 27% with propranolol); coronary events, although not reduced across the board, were reduced by one-third in male non-smokers treated with propranolol; and compared with placebo, all-cause mortality in the actively treated groups was lower in men but higher in women. The implications of these results are discussed. It is hoped that the MRC trial will open the way to a more intelligently targeted approach that may help to reduce the incidence of stroke and myocardial infarction by skillful selection of patients and drugs. By this selection, many patients who are at very low risk or for whom the risks of treatment may outweight the likely benefits will be spared the cost and inconvenience of prolonged treatment.
医学研究委员会（MRC）高血压试验的主要结果于1985年年中公布，更多详细阐述诸如治疗对缺血性心脏病影响等重要问题的论文正在筹备中。本文简要回顾了该试验的一些要点。MRC试验的主要结果是，中风平均减少了约一半（使用苄氟噻嗪时减少69%，使用普萘洛尔时减少27%）；冠心病事件虽然并非全面减少，但在接受普萘洛尔治疗的男性非吸烟者中减少了三分之一；与安慰剂相比，积极治疗组的全因死亡率在男性中较低，在女性中较高。本文讨论了这些结果的意义。希望MRC试验能为一种更具针对性的方法开辟道路，通过巧妙地选择患者和药物，有助于降低中风和心肌梗死的发病率。通过这种选择，许多低风险患者或那些治疗风险可能超过潜在益处的患者将免受长期治疗的费用和不便。
