Nekrasova A A, Mergenbaeva T K, Ostapenko T V, Suvorov Iu I, Konstantinov E N
Biull Vsesoiuznogo Kardiol Nauchn Tsentra AMN SSSR. 1982;5(1):62-8.
One hundred fifty eight patients with essential hypertension (both in- and out-patients) at stages IIA and IIB were treated with diuretics: furosemide (120 mg/day) during three days followed by hydrochlorothiazide in the doses that allow maintaining the renal sodium and water transport of the changed level. Criteria developed for prognosis of the efficiency of diuretic therapy according to the degree of reduction of the mean BP and plasma renin activity after 3-day furosemide intake; indications were worked out for a simultaneous prescription of the potassium-sparing drug amiloride. A good hypotensive effect was noted (reduction of the mean BP by 10 mm Hg) during the first month of treatment in 60 and 70% of in-patients, and in 22 and 40% out-patients with IIB and IIA stages of the disease, respectively. During 6 months of prolonged treatment with diuretics (1-2 years) the sensitivity of the patients to the therapy was increased that permitted the dose of hydrochlorothiazide to be reduced to 25 mg a day or every other day. Patients with good hypotensive effect of therapy were noted to have less pronounced degree of activation of the renin-angiotensin-aldosterone system, than that in patients with ineffective treatment.
158例IIA期和IIB期原发性高血压患者（包括住院患者和门诊患者）接受了利尿剂治疗：先给予速尿（120毫克/天），持续三天，之后给予氢氯噻嗪，剂量以维持改变水平的肾脏钠和水转运为准。根据服用速尿三天后平均血压和血浆肾素活性的降低程度制定了利尿剂治疗效果预后标准；确定了同时开具保钾药物阿米洛利的指征。在治疗的第一个月，60%的IIB期住院患者和70%的IIA期住院患者，以及22%的IIB期门诊患者和40%的IIA期门诊患者出现了良好的降压效果（平均血压降低10毫米汞柱）。在利尿剂长期治疗6个月（1至2年）期间，患者对治疗的敏感性增加，从而可将氢氯噻嗪的剂量减至25毫克/天或隔日服用。治疗有良好降压效果的患者，其肾素-血管紧张素-醛固酮系统的激活程度比治疗无效的患者轻。
