Croog S H, Sudilovsky A, Levine S, Testa M A
J Hypertens Suppl. 1987 Feb;5(1):S47-54.
Relationships between antihypertensive medications and selected aspects of work performance and absenteeism were explored in a multicentre, randomized, double-blind, clinical trial with 626 male hypertensive patients assigned to regimens of captopril, methyldopa or propranolol, either alone or supplemented as needed by a diuretic for blood pressure control. Patients previously on antihypertensive therapy did not differ from new patients in work absenteeism, both before and throughout the clinical trial. After a 24-week treatment period patients on captopril alone improved significantly over baseline in work-performance measures of mental acuity and job satisfaction-morale, while significant worsening in the methyldopa group and no change in the propranolol group occurred among patients given these drugs alone. When 24-week changes between groups not on diuretic were compared, significant differences in the measures appeared in favour of captopril. However, patients also taking a diuretic did not differ from baseline either within or between the three groups. Withdrawal from the trial because of lethargy and fatigue was significantly greater among patients on methyldopa and propranolol than among those receiving captopril. Absenteeism did not differ between the drug groups. The study shows that there are measurable differences in the impact of the antihypertensive drugs on aspects of work performance, and it underlines the importance of considering this factor in assigning patients to therapy.
在一项多中心、随机、双盲临床试验中，研究了抗高血压药物与工作表现及旷工的某些方面之间的关系。该试验将626名男性高血压患者分配至卡托普利、甲基多巴或普萘洛尔治疗方案，单独使用或根据需要补充利尿剂以控制血压。在临床试验之前及整个过程中，既往接受过抗高血压治疗的患者与新患者在旷工方面并无差异。经过24周的治疗期后，单独使用卡托普利的患者在智力敏锐度和工作满意度-士气等工作表现指标上较基线有显著改善，而单独使用这些药物的患者中，甲基多巴组出现显著恶化，普萘洛尔组则无变化。当比较未使用利尿剂的组之间的24周变化时，各项指标出现了有利于卡托普利的显著差异。然而，同时服用利尿剂的患者在三组内及组间与基线相比均无差异。因无精打采和疲劳而退出试验的情况在服用甲基多巴和普萘洛尔的患者中比接受卡托普利治疗的患者更为显著。各药物组之间的旷工情况并无差异。该研究表明，抗高血压药物对工作表现的影响存在可测量的差异，并强调了在为患者分配治疗方案时考虑这一因素的重要性。
