Ferguson R K, Rothenberg R J, Nies A S
Circulation. 1976 Jul;54(1):32-7. doi: 10.1161/01.cir.54.1.32.
The relative benefits and risks of reserpine and guanethidine were compared in patients with thiazide-treated mild to moderate hypertension (diastolic pressure 95-115 mm Hg). Forty-nine ambulant patients )30 men, 19 women) were treated throughout the study with hydrochlorothiazide, 50 mg/day. In this double blind crossover study each drug was added in graded increments until a predetermined therapeutic response was obtained, blood pressure measurements and side effect scores were evaluated biweekly. Major conclusions of the study were: 1) guanethidine, as well as reserpine, will reduce mild to moderate blood pressures to normal; 2) in most cases, side effects which did occur while taking guanethidine or reserpine were well tolerated and neither drug was clearly superior. Side effects associated with larger doses of guanethidine employed in severe hypertension were absent or only slightly bothersome. Thus, guanethidine apppears to have a good benefit-to-risk ratio in the therapy of mild to moderate hypertension and offers a number of advantages over drugs commonly used in this syndrome. This study refutes the common belief that guanethidine must be reserved only for the treatment of more severe degrees of hypertension.
在接受噻嗪类药物治疗的轻度至中度高血压（舒张压95 - 115毫米汞柱）患者中，比较了利血平和胍乙啶的相对益处和风险。49例非卧床患者（30名男性，19名女性）在整个研究过程中接受氢氯噻嗪治疗，剂量为每日50毫克。在这项双盲交叉研究中，每种药物均以递增剂量添加，直至获得预定的治疗反应，每两周评估一次血压测量值和副作用评分。该研究的主要结论如下：1）胍乙啶以及利血平均可将轻度至中度血压降至正常；2）在大多数情况下，服用胍乙啶或利血平期间出现的副作用耐受性良好，两种药物均无明显优势。重度高血压中使用较大剂量胍乙啶相关的副作用不存在或仅略有困扰。因此，胍乙啶在轻度至中度高血压治疗中似乎具有良好的效益风险比，并且与该综合征常用药物相比具有许多优势。本研究反驳了胍乙啶必须仅保留用于治疗更严重程度高血压的普遍观念。
