Jounela A J, Lilja M, Lumme J, Mörlin C, Hoyem A, Wessel-Aas T, Borrild N J
Department of Hypertension Clinic, Deaconess Hospital, Oulu, Finland.
Blood Press. 1994 Jul;3(4):231-5. doi: 10.3109/08037059409102262.
Thiazide diuretics are widely used in the drug treatment of hypertension but their dose-response curves for the antihypertensive and adverse metabolic effects differ. To characterize the lower end of the dose-response curve a double-blind, parallel group trial was performed as multicentre study in Scandinavia. One hundred and eleven patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo) were randomly allocated to various doses of hydrochlorothiazide (3, 6, 12.5 or 25 mg) or placebo for 6 weeks. Blood pressure and biochemical variables (plasma renin activity, serum potassium, magnesium, urate, fasting glucose, total cholesterol, HDL-cholesterol, triglycerides and apolipoproteins A1 and B were measured. 12.5 mg hydrochlorothiazide had a borderline effect on blood pressure whilst 25 mg had a definite antihypertensive effect. Biochemical changes were seen in plasma renin activity, serum potassium and urate after the 12.5 and 25 mg dose. Three and 6 mg had no effect on blood pressure or metabolic parameters.
噻嗪类利尿剂广泛应用于高血压的药物治疗，但它们在降压和不良代谢效应方面的剂量反应曲线有所不同。为了描述剂量反应曲线的低端情况，在斯堪的纳维亚进行了一项多中心双盲平行组试验。111例新诊断或既往接受过治疗的轻度至中度高血压患者（安慰剂治疗4周后未治疗的舒张压为95 - 115 mmHg）被随机分配至不同剂量的氢氯噻嗪（3、6、12.5或25 mg）或安慰剂组，治疗6周。测量血压和生化指标（血浆肾素活性、血清钾、镁、尿酸盐、空腹血糖、总胆固醇、高密度脂蛋白胆固醇、甘油三酯以及载脂蛋白A1和B）。12.5 mg氢氯噻嗪对血压有临界效应，而25 mg有明确的降压作用。12.5 mg和25 mg剂量后，血浆肾素活性、血清钾和尿酸盐出现生化变化。3 mg和6 mg对血压或代谢参数无影响。
