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使用抗高血压药物吲达帕胺治疗期间的血清脂蛋白

Serum lipoproteins during treatment with the antihypertensive agent indapamide.

作者信息

Gerber A, Weidmann P, Bianchetti M G, Ferrier C, Laederach K, Mordasini R, Riesen W, Bachmann C

出版信息

Hypertension. 1985 Nov-Dec;7(6 Pt 2):II164-9. doi: 10.1161/01.hyp.7.6_pt_2.ii164.

Abstract

Considering the documented, potentially undesirable influence of various thiazide-type or loop diuretics on serum lipoproteins, we prospectively investigated in 69 men (mean age +/- SEM, 32 +/- 1 years) the metabolic effects of the new diuretic-antihypertensive compound indapamide. Compared to placebo, indapamide (2.5 mg/day) given for 6 to 8 weeks lowered (p less than 0.02 to less than 0.001) blood pressure (supine values from 148/98 +/- 3/2 to 137/93 +/- 3/2) in 29 men with mild to moderate essential hypertension, but not in 40 healthy men. In both groups, significant (p less than 0.05 to less than 0.001) decreases in body weight (-0.8 kg) and plasma potassium (-0.6 mmol/L), and increases in plasma uric acid (+20%), renin activity (+200%), and aldosterone documented good compliance. There were no significant changes in total cholesterol (in all subjects, from 208 +/- 6 to 213 +/- 6 mg/dl), low- or very low-density lipoprotein (VLDL) cholesterol (127 +/- 6 to 129 +/- 6 and 21 +/- 1 to 21 +/- 2 respectively), high-density lipoprotein cholesterol (50 +/- 1 to 51 +/- 1 mg/dl), total triglycerides (Tg) (108 +/- 5 to 112 +/- 6 mg/dl), VLDL-Tg, apoproteins A1 and A2, plasma glucose, epinephrine, norepinephrine, sodium, calcium, magnesium, and creatinine; apoprotein B (84 +/- 2 to 88 +/- 3 mg/dl) and plasma insulin after glucose loading dose tended to be increased minimally. The absence of distinct lipoprotein alterations after short-term indapamide treatment may be of clinical and epidemiological interest.

摘要

鉴于各种噻嗪类或袢利尿剂对血清脂蛋白有文献记载的潜在不良影响,我们前瞻性地研究了新型利尿降压化合物吲达帕胺对69名男性(平均年龄±标准误,32±1岁)的代谢作用。与安慰剂相比,29名轻度至中度原发性高血压男性服用吲达帕胺(2.5毫克/天)6至8周后血压降低(p<0.02至<0.001)(仰卧位血压从148/98±3/2降至137/93±3/2),但40名健康男性血压未降低。在两组中,体重(-0.8千克)和血浆钾(-0.6毫摩尔/升)显著降低(p<0.05至<0.001),血浆尿酸(+20%)、肾素活性(+200%)和醛固酮增加,表明依从性良好。总胆固醇(所有受试者从208±6至213±6毫克/分升)、低密度或极低密度脂蛋白(VLDL)胆固醇(分别从127±6至129±6和21±1至21±2)、高密度脂蛋白胆固醇(50±1至51±1毫克/分升)、总甘油三酯(Tg)(108±5至112±6毫克/分升)、VLDL-Tg、载脂蛋白A1和A2、血浆葡萄糖、肾上腺素、去甲肾上腺素、钠、钙、镁和肌酐均无显著变化;载脂蛋白B(84±2至88±3毫克/分升)和葡萄糖负荷剂量后的血浆胰岛素略有增加趋势。短期吲达帕胺治疗后未出现明显的脂蛋白改变,这可能具有临床和流行病学意义。

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