Hauner H, Meissner C
Diabetes-Forschungsinstitut an der Heinrich-Heine-Universität Düsseldorf.
Med Klin (Munich). 1994 Aug 15;89(8):403-9.
Aim of this study was to investigate the occurrence of metabolic abnormalities in patients with newly diagnosed essential hypertension and to assess the effects of a blood pressure lowering drug therapy on the respective variables.
Twenty-six hypertensive subjects (12 female, 14 male) were included in the study. Twenty-one normotensive subjects (9 female, 12 male) served as a control group. During an oral glucose tolerance test the hypertensive subjects had higher blood glucose and serum insulin levels than the controls. The hypertensive patients also showed higher triglyceride concentrations and a more abdominal pattern of body fat distribution. In addition, the women with essential hypertension exhibited a higher free androgen index (32.2 +/- 14.8 vs 20.1 +/- 15.0%, p < 0.05) than the women of the control group. After a 3 to 6 month treatment period with nifedipine or nitrendipine the elevated blood pressure of the hypertensives was significantly reduced. In a second glucose tolerance test carried out in 13 patients blood glucose, serum insulin and triglyceride concentrations were significantly lower compared to the pretreatment period. The other metabolic and hormonal variables remained unchanged.
This observation raises the question, whether a long-term vasodilatating antihypertensive therapy can improve the metabolic abnormalities found in patients with essential hypertension.
本研究旨在调查新诊断的原发性高血压患者代谢异常的发生情况，并评估降压药物治疗对各相关变量的影响。
26名高血压受试者（12名女性，14名男性）纳入本研究。21名血压正常的受试者（9名女性，12名男性）作为对照组。在口服葡萄糖耐量试验期间，高血压受试者的血糖和血清胰岛素水平高于对照组。高血压患者还表现出更高的甘油三酯浓度和更具腹部型的体脂分布模式。此外，原发性高血压女性的游离雄激素指数（32.2±14.8对20.1±15.0%，p<0.05）高于对照组女性。在用硝苯地平或尼群地平治疗3至6个月后，高血压患者升高的血压显著降低。在13名患者进行的第二次葡萄糖耐量试验中，血糖、血清胰岛素和甘油三酯浓度与治疗前相比显著降低。其他代谢和激素变量保持不变。
这一观察结果提出了一个问题，即长期的血管舒张性抗高血压治疗是否能改善原发性高血压患者中发现的代谢异常。
