Ames R P
J Cardiovasc Pharmacol. 1984;6 Suppl 3:S466-73.
In summary, diuretic-based antihypertensive therapy causes glucose intolerance and raises glycohemoglobin concentrations as well as blood cholesterol and triglycerides. Various indices of glucose intolerance correlate with alterations in lipid concentrations. The correlations suggest that these metabolic disturbances are linked or have a common mechanism. When the three CHD risk factors of glucose, cholesterol and SBP are considered together, the net change during diuretic-based treatment may not be uniformly favorable. Other antihypertensive regimens might produce a move salubrious effect on the risk factors. Once identified, such regimens will need to be tested against diuretic regimens to ascertain whether the theoretical advantage suggested by risk factor analysis translates into a reduction in real-life coronary events.
总之,基于利尿剂的降压治疗会导致葡萄糖不耐受,提高糖化血红蛋白浓度以及血液胆固醇和甘油三酯水平。葡萄糖不耐受的各种指标与脂质浓度的变化相关。这些相关性表明,这些代谢紊乱是相互关联的或具有共同的机制。当同时考虑葡萄糖、胆固醇和收缩压这三个冠心病危险因素时,基于利尿剂的治疗期间的净变化可能并非一律有利。其他降压方案可能会对这些危险因素产生更有益的影响。一旦确定,就需要将这些方案与利尿剂方案进行对比测试,以确定危险因素分析所表明的理论优势是否能转化为实际生活中冠心病事件的减少。