Diehm C, Mörl H, Schettler G
Z Kardiol. 1983 Jan;72(1):44-7.
Up to now betablockers were regarded as relatively contraindicated in patients with peripheral vascular disease (PVD). The effects of metoprolol were studied in hypertensive patients (stage I, WHO) with PVD of pelvic and thigh type (stage II according to Fontaine). An initial dose of 100 mg metoprolol followed by 100 mg 90 min after the first oral administration, twice a day was administered for 8 weeks. Blood pressure decreased from 181/105 to 163/96 mm Hg. Pulse rate was lowered from 72 to 68/min (p less than 0.001). Estimated doppler pressure in the posterior tibial artery decreased from 123 to 119 mm Hg. Venous occlusion plethysmography showed a slight but not significant decrease at rest and during reactive hyperemia. During long-term treatment the pain-free walking distance increased significantly from 225 to 348 m. No side effects were seen. Thus, metoprolol as a beta 1-selective betablocker is not contraindicated in patients with intermittent claudication.
到目前为止,β受体阻滞剂在周围血管疾病(PVD)患者中被视为相对禁忌。研究了美托洛尔对患有盆腔和大腿型PVD(根据Fontaine分级为II期)的高血压患者(WHO I期)的影响。初始剂量为美托洛尔100mg,首次口服给药90分钟后再给予100mg,每日两次,给药8周。血压从181/105 mmHg降至163/96 mmHg。脉搏率从72次/分钟降至68次/分钟(p<0.001)。胫后动脉的估计多普勒压力从123 mmHg降至119 mmHg。静脉阻塞体积描记法显示,静息时和反应性充血期间略有下降,但不显著。长期治疗期间,无痛步行距离从225米显著增加到348米。未观察到副作用。因此,美托洛尔作为一种β1选择性β受体阻滞剂,在间歇性跛行患者中并非禁忌。