Roos J C, Boer P, Koomans H A, Geyskes G G, Dorhout Mees E J
Eur J Clin Pharmacol. 1981 Jan;19(2):107-12. doi: 10.1007/BF00568396.
The short- and long-term effects of diuretic treatment with chlorthalidone 50 mg/day on haemodynamic and hormonal parameters in patients with essential hypertension (WHO grade I) were investigated. After three days of treatment, all patients showed a rise in plasma renin activity (PRA), plasma aldosterone (PA), urinary norepinephrine excretion (UNE) and heart rate (HR), and a decrease in body weight (BW) and extracellular volume (ECV) and blood volume (BV); the change in blood pressure (BP) was variable. The changes in BP were correlated with those in BV. After three months of therapy, the signs of volume depletion tended to fade, but the lower ECV persisted. In contrast to the 4-day study, after three months the change in BP correlated inversely with changes in ECV and renin dependency (saralasin response), and positively with PRA and changes in UNE. It is concluded that the BP response to diuretic treatment is determined by the adaptation with time of the haemodynamic reactions to the volume-depleted state. Whether this adaptation will take place cannot be predicted from the control values of the parameters studied, or from acute changes observed during the first days of treatment.
研究了每日服用50毫克氯噻酮进行利尿治疗对原发性高血压（世界卫生组织I级）患者血流动力学和激素参数的短期和长期影响。治疗三天后，所有患者的血浆肾素活性（PRA）、血浆醛固酮（PA）、尿去甲肾上腺素排泄量（UNE）和心率（HR）均升高，体重（BW）、细胞外液量（ECV）和血容量（BV）均降低；血压（BP）变化不一。血压变化与血容量变化相关。治疗三个月后，容量耗竭的体征趋于消退，但较低的细胞外液量持续存在。与为期4天的研究不同，三个月后血压变化与细胞外液量变化和肾素依赖性（沙拉新反应）呈负相关，与血浆肾素活性和尿去甲肾上腺素排泄量变化呈正相关。得出的结论是，利尿剂治疗的血压反应取决于血流动力学反应随时间对容量耗竭状态的适应情况。这种适应是否会发生，无法根据所研究参数的对照值或治疗开始后几天内观察到的急性变化来预测。
