Os I, Bratland B, Dahlöf B, Gisholt K, Syvertsen J O, Tretli S
Department of Nephrology, Ullevål University Hospital, Oslo, Norway.
Am J Hypertens. 1993 Aug;6(8):688-92. doi: 10.1093/ajh/6.8.688.
Single cardiovascular risk factor intervention is probably not sufficient to prevent atherosclerosis progression. There is a lack of data on concomitant use of hypocholesterolemic agents and antihypertensive drugs with respect to possible interactions and adverse experiences. We studied 293 patients (below 65 years of age) under treatment with either lisinopril (n = 144) or nifedipine (n = 149) for mild to moderate hypertension for 10 weeks, and with serum cholesterol above 6.5 mmol/L, who were randomized to either lovastatin 20 mg every day or placebo in a double-blind, double-dummy design for 6 weeks. Lovastatin effectively lowered cholesterol by 16% and 15% in the lisinopril and nifedipine group respectively (P < .01 compared to placebo for both groups) without any negative impact on the antihypertensive efficacy of either lisinopril or nifedipine. The drugs in combination were well tolerated and did not affect the well-being of the patients, and did not cause any more adverse effects than the antihypertensive agents alone. Liver enzymes increased slightly during lovastatin therapy, while no case of myopathy was reported. Combined therapy with lovastatin and antihypertensive therapy can be safely undertaken.
单一心血管危险因素干预可能不足以预防动脉粥样硬化进展。关于降胆固醇药物和抗高血压药物联合使用时可能存在的相互作用及不良反应，目前缺乏相关数据。我们研究了293例（年龄在65岁以下）轻度至中度高血压患者，这些患者接受赖诺普利（n = 144）或硝苯地平（n = 149）治疗10周，且血清胆固醇高于6.5 mmol/L，他们被随机分为两组，在双盲、双模拟设计下，一组每天服用20 mg洛伐他汀，另一组服用安慰剂，为期6周。在赖诺普利组和硝苯地平组中，洛伐他汀分别有效降低胆固醇16%和15%（两组与安慰剂相比P均<0.01），且对赖诺普利或硝苯地平的降压疗效均无负面影响。联合用药耐受性良好，不影响患者的健康状况，且与单独使用抗高血压药物相比，未引起更多不良反应。洛伐他汀治疗期间肝酶略有升高，未报告有任何肌病病例。洛伐他汀与抗高血压治疗联合应用可安全进行。
