β受体阻滞剂和利尿剂降压治疗期间的血清脂蛋白：一项对照长期比较试验。

Serum lipoproteins during antihypertensive therapy with beta blockers and diuretics: a controlled long-term comparative trial.

作者信息

Middeke M, Weisweiler P, Schwandt P, Holzgreve H

出版信息

Clin Cardiol. 1987 Feb;10(2):94-8. doi: 10.1002/clc.4960100204.

Abstract

The influence of hydrochlorothiazide and atenolol on serum lipoproteins was investigated in a randomized, prospective study on 68 men with essential hypertension. Cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDH) cholesterol, triglycerides, and the apolipoproteins AI and B were followed up to 42 months after starting therapy. Following atenolol serum (HDL) cholesterol decreased and serum triglycerides increased significantly (p less than 0.01) from 6 to 42 months. After hydrochlorothiazide serum triglycerides, LDL cholesterol and total cholesterol all increased significantly (p less than 0.01) from 12 to 42 months. The changes were more pronounced under higher doses with beta blockade, but not with diuretics. Thus, both atenolol and hydrochlorothiazide have adverse but different effects on serum lipoproteins after long-term administration. Continuing investigation is necessary to determine whether these side effects decrease the benefit of blood pressure reduction in patients with hypertension.

摘要

在一项针对68名原发性高血压男性患者的随机前瞻性研究中，研究了氢氯噻嗪和阿替洛尔对血清脂蛋白的影响。在开始治疗后的42个月内，对胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDH）胆固醇、甘油三酯以及载脂蛋白AI和B进行了跟踪监测。服用阿替洛尔后，血清（HDL）胆固醇从6个月到42个月显著下降，血清甘油三酯显著升高（p<0.01）。服用氢氯噻嗪后，血清甘油三酯、低密度脂蛋白胆固醇和总胆固醇从12个月到42个月均显著升高（p<0.01）。在较高剂量的β受体阻滞剂治疗下，这些变化更为明显，但利尿剂治疗则不然。因此，长期服用阿替洛尔和氢氯噻嗪对血清脂蛋白均有不良但不同的影响。有必要继续进行研究，以确定这些副作用是否会降低高血压患者降压治疗的益处。