Eliasson K, Kahan T, Hylander B, Hjemdahl P
J Hypertens Suppl. 1986 Dec;4(6):S263-5.
In a study aimed at comparing the effects of beta-blockers and thiazide diuretics on responses to stressful provocations, 45 essential hypertensives (WHO I-II) were treated with either the selective beta-blocker metoprolol (METO), the non-selective beta-blocker propranolol (PROP) or hydrochlorothiazide (HTZ) for 6 months. Blood pressure, heart rate and plasma catecholamines were measured in connection with a mental stress test and a cold pressor test before and during therapy. All drugs reduced outpatient blood pressure similarly, but beta-blockade reduced blood pressure and heart rate levels more efficiently at rest and during stress in the laboratory. Heart rate reactivity to stress was reduced mostly by beta-blockade during mental stress. Blood pressure and sympatho-adrenal reactivity were unchanged by therapy. Stress reactivity failed to predict antihypertensive responses. The results suggest that beta-blockade may be more effective than diuretic treatment in reducing blood pressure levels and cardiac workload as assessed by the rate pressure product in stressful situations.
在一项旨在比较β受体阻滞剂和噻嗪类利尿剂对压力激发反应影响的研究中，45名原发性高血压患者（WHO I-II级）接受了选择性β受体阻滞剂美托洛尔（METO）、非选择性β受体阻滞剂普萘洛尔（PROP）或氢氯噻嗪（HTZ）治疗6个月。在治疗前和治疗期间，结合精神应激试验和冷加压试验测量血压、心率和血浆儿茶酚胺。所有药物降低门诊血压的效果相似，但在实验室休息和应激期间，β受体阻滞更有效地降低血压和心率水平。在精神应激期间，β受体阻滞主要降低心率对应激的反应性。治疗后血压和交感-肾上腺反应性未改变。应激反应性无法预测降压反应。结果表明，在应激情况下，通过速率压力乘积评估，β受体阻滞在降低血压水平和心脏负荷方面可能比利尿剂治疗更有效。
