Chalmers J P, West M J, Wing L M, Bune A J, Graham J R
Clin Exp Hypertens A. 1984;6(6):1077-93. doi: 10.3109/10641968409039582.
Four placebo controlled, randomised crossover studies were carried out to investigate the effects of non-steroidal anti-inflammatory drugs and analgesics on blood pressure control in treated hypertensive patients. Twelve patients completed one study comparing indomethacin, 25 mg tds, with placebo in 2 six week phases; there were increases in mean blood pressure (p less than 0.01) of 9 mm Hg (casual), 8 mm Hg (supine) and 10 mm Hg (standing) in the indomethacin phase accompanied by a 50% reduction in plasma renin activity (p less than 0.05) and a 47% decrease in plasma aldosterone concentration (p less than 0.05). Similar studies on aspirin-SR, 650 mg daily (19 patients), and paracetamol, 1 g 8th hourly (20 patients), revealed only small changes in blood pressure, with a 2 mm Hg increase in supine diastolic blood pressure during aspirin therapy and a 4 mm Hg increase in supine and standing systolic blood pressure during paracetamol therapy (p less than 0.05 for both). Nineteen patients completed a study with 4 three week phases, taking placebo, naproxen 250 mg mane and 500 mg nocte, sulindac 200 mg bd, and aspirin-SR 1950 mg bd. All three active agents depressed plasma renin activity and plasma aldosterone concentration. Neither sulindac nor aspirin caused any significant increases in blood pressure, and naproxen had little effect, though it did cause a 4 mm Hg increase in standing systolic pressure (p less than 0.05). We conclude that the effects of indomethacin on control of blood pressure in treated hypertensive patients are not exhibited to the same extent by other drugs investigated, and that they are not dependent on the concomitant decreases in plasma renin activity or plasma aldosterone concentration. The importance of inhibition of prostaglandin synthesis remains unclear.
开展了四项安慰剂对照的随机交叉研究，以调查非甾体抗炎药和镇痛药对接受治疗的高血压患者血压控制的影响。12名患者完成了一项研究，该研究在两个为期六周的阶段中，将25毫克每日三次的吲哚美辛与安慰剂进行比较；在吲哚美辛阶段，平均血压（p<0.01）分别有9毫米汞柱（随意）、8毫米汞柱（仰卧位）和10毫米汞柱（站立位）的升高，同时血浆肾素活性降低50%（p<0.05），血浆醛固酮浓度降低47%（p<0.05）。对每日服用650毫克阿司匹林缓释片（19名患者）和每8小时服用1克对乙酰氨基酚（20名患者）的类似研究显示，血压仅有微小变化，阿司匹林治疗期间仰卧位舒张压升高2毫米汞柱，对乙酰氨基酚治疗期间仰卧位和站立位收缩压升高4毫米汞柱（两者p均<0.05）。19名患者完成了一项有四个为期三周阶段的研究，分别服用安慰剂、每日早晨服用250毫克和夜间服用500毫克萘普生、每日两次服用200毫克舒林酸以及每日两次服用1950毫克阿司匹林缓释片。所有三种活性药物均降低了血浆肾素活性和血浆醛固酮浓度。舒林酸和阿司匹林均未导致血压显著升高，萘普生影响较小，不过确实使站立位收缩压升高了4毫米汞柱（p<0.05）。我们得出结论，在所研究的其他药物中，吲哚美辛对接受治疗的高血压患者血压控制的影响程度不同，且这些影响并不依赖于血浆肾素活性或血浆醛固酮浓度的同时降低。前列腺素合成抑制的重要性仍不清楚。
