Goldman A I, Steele B W, Schnaper H W, Fitz A E, Frohlich E D, Perry H M
JAMA. 1980 Oct 10;244(15):1691-5. doi: 10.1001/jama.244.15.1691.
In a joint Veterans Administration-National Heart, Lung, and Blood Institute study of mild hypertension, 1,012 men and women, 21 to 50 years of age and with diastolic pressure from 85 to 105 mm Hg, were randomized into two double-blind treatment groups. Subjects in the active group received chlorthalidone or chlorthalidone plus reserpine, while the other subjects received matching placebo tablets. After one year of treatment, the chlorthalidone group had increases of 10.0 +/- 1.8 (SE) mg/dL in total cholesterol level, 9.8 +/- 5.2 mg/dL in triglyceride level, and 12.6 +/- 3.4 mg/dL in low-density lipoprotein-cholesterol level above the changes in the placebo group. There was no difference in high-density lipoprotein changes between the two groups (0.1 +/- 0.8 mg/dL). The possible net effect on risk of increasing lipid values while lowering pressure in the long-term treatment of mild hypertension with thiazides or related diuretics must be further evaluated.
在退伍军人管理局与国家心肺血液研究所联合开展的一项关于轻度高血压的研究中,1012名年龄在21至50岁之间、舒张压在85至105毫米汞柱的男性和女性被随机分为两个双盲治疗组。活性组的受试者接受氯噻酮或氯噻酮加利血平治疗,而其他受试者则服用匹配的安慰剂片。治疗一年后,氯噻酮组的总胆固醇水平升高了10.0±1.8(标准误)毫克/分升,甘油三酯水平升高了9.8±5.2毫克/分升,低密度脂蛋白胆固醇水平升高了12.6±3.4毫克/分升,高于安慰剂组的变化。两组之间的高密度脂蛋白变化没有差异(0.1±0.8毫克/分升)。噻嗪类或相关利尿剂长期治疗轻度高血压时,在降低血压的同时增加血脂值的风险可能产生的净效应必须进一步评估。