Pedersen O L, Mikkelsen E
Eur J Clin Pharmacol. 1979 Nov;16(5):311-7. doi: 10.1007/BF00605627.
103 patients with arterial hypertension were treated with timolol + placebo for 7 weeks in a multicentre trial, and with timolol + hydrochlorothiazide and amiloride for a further 7-week period. The decrease in blood pressure (BP) produced by timolol alone was influenced neither by the dose of timolol, initial heart rate, magnitude of pretreatment BP nor by age. 64% of the patients less than 40 years of ages, and 48% of the older patients, were well regulated on beta-blocker monotherapy. When the diuretic was given in addition, the BP response in the older age group improved, whereas younger patients showed no change. A significant correlation was found between age or magnitude of untreated BP and the decrease in BP caused by the diuretic. The cardiothoracic ratio increased significantly on timolol alone, whereas no change was found on the combined therapy. Weight changes in the two different treatment periods showed a significant correlation, but they were not related to the observed reduction in BP. The results suggest that in younger patients, beta-blocker therapy is just as effective as a combined treatment with a diuretic, whereas in older patients considerably better regulation is achieved by combined therapy.
在一项多中心试验中,103例动脉高血压患者先用噻吗洛尔+安慰剂治疗7周,然后再用噻吗洛尔+氢氯噻嗪和阿米洛利治疗7周。单独使用噻吗洛尔引起的血压下降不受噻吗洛尔剂量、初始心率、治疗前血压幅度或年龄的影响。64%年龄小于40岁的患者和48%年龄较大的患者,仅用β受体阻滞剂单药治疗就能使血压得到良好控制。当加用利尿剂时,老年组的血压反应有所改善,而年轻患者则无变化。发现年龄或未治疗时的血压幅度与利尿剂引起的血压下降之间存在显著相关性。单独使用噻吗洛尔时心胸比率显著增加,而联合治疗时未发现变化。两个不同治疗期的体重变化显示出显著相关性,但它们与观察到的血压降低无关。结果表明,在年轻患者中,β受体阻滞剂治疗与利尿剂联合治疗同样有效,而在老年患者中,联合治疗能使血压得到更好的控制。