Bengtsson C
Acta Pharmacol Toxicol (Copenh). 1984;54 Suppl 1:67-70. doi: 10.1111/j.1600-0773.1984.tb03635.x.
A review is made of the metabolic side effects of diuretics and beta-adrenoceptorblockers. The review is based on results from a population study, performed by the author, of women and on a survey of the literature. While diuretics give rise to hypokalemia, which may be of clinical importance, beta-adrenoceptorblockers tend to increase the serum potassium levels. This does not, however, seem to be of clinical significance. Both diuretics and beta-adrenoceptorblockers increase serum uric acid levels. Beta-adrenoceptorblockers increase serum triglycerides, which is not observed when diuretics are used. Total cholesterol in serum is usually not changed either by diuretics or by beta-adrenoceptorblockers. These drugs seem to have no influence on body weight when studied during long-term treatment. A further deterioration of glucose tolerance may be expected in subjects with an initially impaired glucose tolerance when diuretics are administered, while results from studies on glucose tolerance in subjects taking beta-adrenoceptorblockers have been controversial. Diabetes mellitus seems to be more common among subjects on diuretics as well as among subjects on beta-adrenoceptorblockers, but as yet it cannot be stated whether this is an effect of the antihypertensive drugs or of the hypertension per se or of some other factor or factors.
本文综述了利尿剂和β-肾上腺素能受体阻滞剂的代谢副作用。该综述基于作者对女性进行的一项人群研究结果以及对文献的调查。利尿剂会导致低钾血症,这可能具有临床重要性,而β-肾上腺素能受体阻滞剂往往会使血清钾水平升高。然而,这似乎没有临床意义。利尿剂和β-肾上腺素能受体阻滞剂都会使血清尿酸水平升高。β-肾上腺素能受体阻滞剂会使血清甘油三酯升高,而使用利尿剂时未观察到这种情况。利尿剂和β-肾上腺素能受体阻滞剂通常都不会改变血清总胆固醇水平。在长期治疗期间研究时,这些药物似乎对体重没有影响。对于最初糖耐量受损的受试者,使用利尿剂时可能会预期糖耐量进一步恶化,而关于服用β-肾上腺素能受体阻滞剂的受试者糖耐量的研究结果一直存在争议。糖尿病在服用利尿剂的受试者以及服用β-肾上腺素能受体阻滞剂的受试者中似乎更为常见,但目前尚不能确定这是降压药物的作用、高血压本身的作用还是其他某些因素的作用。