Swales J D, Bing R F, Swart S, Thurston H
J Cardiovasc Pharmacol. 1984;6 Suppl 1:S250-5. doi: 10.1097/00005344-198400061-00039.
Twenty-four-hour urinary sodium excretion and plasma renin activity were monitored in 36 patients receiving bendrofluazide as sole antihypertensive therapy. There was no increase in urinary sodium output compared with pretreatment values during a 2-year period, and there is therefore no evidence that an increase in salt appetite as a result of salt depletion occurred. However, plasma renin activity progressively increased over a 2-year period. In five of eight patients who initially had a subnormal renin response to the diuretic, plasma renin level rose into the normal stimulated range. When administration of the diuretic was stopped in 10 patients after a mean treatment period of 49 months, plasma renin activity promptly fell and weight increased significantly, although blood pressure did not rise. However, on rechallenging with bendrofluazide 28 days later, a greater response was observed than when treatment was originally instituted. Further, three of five patients with low renin hypertension had a normal response on the second occasion. Thus prolonged diuretic therapy has a persistent effect on the activity of the renin-angiotensin system as well as on blood pressure for at least 4 weeks after the discontinuation of diuretics.
对36例接受苄氟噻嗪作为唯一抗高血压治疗的患者进行了24小时尿钠排泄和血浆肾素活性监测。在2年期间，与治疗前值相比，尿钠排出量没有增加，因此没有证据表明因盐耗竭导致盐食欲增加。然而，在2年期间血浆肾素活性逐渐升高。最初对利尿剂肾素反应低于正常的8例患者中，有5例血浆肾素水平升至正常刺激范围。在平均治疗49个月后，10例患者停用利尿剂，血浆肾素活性迅速下降，体重显著增加，尽管血压没有升高。然而，28天后再次给予苄氟噻嗪时，观察到的反应比最初开始治疗时更大。此外，5例低肾素性高血压患者中有3例在第二次用药时有正常反应。因此，长期利尿剂治疗对肾素-血管紧张素系统的活性以及血压在停用利尿剂后至少4周内有持续影响。
