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β受体阻滞剂与利尿剂及其联合应用对高血压患者运动试验期间血压及压力-心率乘积的影响(作者译)

[The effect of beta-receptor antagonists and diuretics and their combination on blood pressure and pressure-rate product during ergometric work in hypertensive patients (author's transl)].

作者信息

Franz I W

出版信息

Z Kardiol. 1982 Jan;71(2):129-37.

PMID:7072313
Abstract
  1. Hypertensive patients are particularly endangered by disproportionately high increases in blood pressure during daily physical and emotional activity. For this reason, antihypertensive drugs should also be able to influence there pressure changes. 2. Therefore the ability of the beta-receptor antagonist acebutolol (400 mg/die) and of the diuretic mefrusid (25 mg/die) to reduce exercise-induced increases in blood pressure and pressure-rate product during and after standardized ergometric work (50--100 watts) was compared in a within-patient study of 42 outpatients with arterial hypertension (stage 1 to 2, WHO) aged 18 to 50 years. 3. Both drugs resulted in a significant reduction of systolic (p less than 0.05-p less than 0.001) and diastolic (p less than 0.05-p less than 0.001) blood pressure at rest. However, systolic and diastolic blood pressure (p less than 0.001) and pressure-rate product (p less than 0.001) during exercise were only significantly reduced by acebutolol. 4. The strongest blood pressure lowering effect under all conditions could be proven for the free and fixed combination of acebutolol and mefrusid. 5. From these findings it is concluded: (1) beta-adreno-receptor blocking agents are the drugs of first choice in the baseline therapy of mild to moderate arterial hypertension, (2) diuretic drugs potentiate the antihypertensive effect of beta-blocking agents. 6. This therapeutic regimen is recommended especially for hypertensives with ischemic heart disease, because diuretics fail to reduce pressure-rate product as a measure of myocardial O2-consumption.
摘要
  1. 高血压患者在日常身体和情绪活动期间血压不成比例地大幅升高,这使其面临特别大的风险。因此,抗高血压药物也应能够影响这些血压变化。2. 因此,在一项针对42名年龄在18至50岁的动脉高血压(WHO 1至2期)门诊患者的患者内研究中,比较了β受体拮抗剂醋丁洛尔(400毫克/日)和利尿剂美夫西特(25毫克/日)在标准化测力计工作(50 - 100瓦)期间及之后降低运动诱发的血压升高和压力-心率乘积的能力。3. 两种药物均使静息时的收缩压(p小于0.05 - p小于0.001)和舒张压(p小于0.05 - p小于0.001)显著降低。然而,仅醋丁洛尔使运动期间的收缩压和舒张压(p小于0.001)以及压力-心率乘积(p小于0.001)显著降低。4. 在所有条件下,醋丁洛尔与美夫西特的游离和固定组合显示出最强的降压效果。5. 从这些发现可以得出结论:(1)β肾上腺素能受体阻滞剂是轻度至中度动脉高血压基线治疗的首选药物,(2)利尿药物可增强β受体阻滞剂的降压效果。6. 这种治疗方案特别推荐给患有缺血性心脏病的高血压患者,因为利尿剂无法降低作为心肌氧消耗指标的压力-心率乘积。

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