Department of Pharmacology, Lady Hardinge Medical College & Smt. S.K. Hospital, New Delhi, 110001, India.
Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, India.
Curr Hypertens Rep. 2023 Oct;25(10):335-341. doi: 10.1007/s11906-023-01256-2. Epub 2023 Aug 15.
Benzodiazepines, due to their anxiolytic properties, are prescribed to reduce anxiety and insomnia. They might have hypotensive effect via potentiation of the inhibitory effect of gamma-amino butyric acid (GABA) in the central nervous system and vasodilatory properties. However, studies comparing the effect of benzodiazepines in lowering blood pressure (BP) are equivocal. This systematic review and meta-analysis was planned to assess the efficacy of benzodiazepines in reducing blood pressure in short term among hypertensive patients.
Various trials and retrospective analysis conducted previously have reported that benzodiazepines cause short- as well as long-term BP reduction in patients with increased anxiety with hypertension. On the other hand, several studies investigating the efficacy of benzodiazepines in patients with hypertension have reported inconclusive results. The primary question about the effect of benzodiazepines in lowering BP remains unanswered. In this meta-analysis of seven studies, benzodiazepines were found comparable to standard drugs in reducing systolic and diastolic BP in patients having hypertension. Although, the mean difference in systolic BP with benzodiazepines and placebo was statistically not significant, the difference can be considered as clinically meaningful. The current review offers preliminary evidence that benzodiazepines may have antihypertensive properties and may be used as add-on antihypertensive in a subset of patients in short term. The existing data are encouraging, but more clinical trials and mechanistic research are required to ascertain the long-term benefits.
苯二氮䓬类药物具有抗焦虑作用，被开处方用于减轻焦虑和失眠。它们可能通过增强中枢神经系统中γ-氨基丁酸（GABA）的抑制作用和血管扩张作用产生降压作用。然而，比较苯二氮䓬类药物降低血压（BP）效果的研究结果存在争议。本系统评价和荟萃分析旨在评估苯二氮䓬类药物在短期内在高血压患者中降低血压的疗效。
先前进行的各种试验和回顾性分析报告称，苯二氮䓬类药物可在伴有高血压的焦虑症患者中短期和长期降低血压。另一方面，几项研究调查了苯二氮䓬类药物在高血压患者中的疗效，结果报告并不一致。关于苯二氮䓬类药物降低血压效果的主要问题仍未得到解答。在这项对 7 项研究的荟萃分析中，发现苯二氮䓬类药物在降低高血压患者的收缩压和舒张压方面与标准药物相当。尽管苯二氮䓬类药物与安慰剂之间的收缩压平均差异在统计学上无显著意义，但这种差异可被认为具有临床意义。目前的综述提供了初步证据表明，苯二氮䓬类药物可能具有降压特性，并可在短期内作为附加降压药物用于某些高血压患者。现有数据令人鼓舞，但需要更多的临床试验和机制研究来确定其长期益处。
