Hauf-Zachariou U, Widmann L, Zülsdorf B, Hennig M, Lang P D
Department of Clinical Research, Boehringer Mannheim GmbH, Mannheim, Germany.
Eur J Clin Pharmacol. 1993;45(2):95-100. doi: 10.1007/BF00315487.
We have studied 250 patients with mild to moderate essential hypertension (diastolic blood pressure 95-114 mmHg) and dyslipidaemia (high-density lipoprotein cholesterol (HDL-C) below 1.03 mmol.l-1, total cholesterol 5.17-9.05 mmol.l-1, and triglycerides 2.26-5.64 mmol.l-1) in a controlled double-blind, multicentre, parallel group trial. The patients took a fat-modified diet. After a 4-week placebo period, patients who continued to fulfil the selection criteria were randomly allocated to treatment with either carvedilol (a vasodilating beta-blocker) 25-50 mg o.d. (n = 116) or captopril (an ACE inhibitor) 25-50 mg o.d. (n = 117) for 6 months. In both groups there were favourable effects on the serum lipids. The relative changes (medians) in the carvedilol and captopril group were respectively: increase in HDL-C by 11% and 8%, decrease in total cholesterol by 11% and 10%, in low-density lipoprotein cholesterol by 16% and 12%, and in triglycerides by 13% and 14%. Equivalence of the two treatments was confirmed for the target variable change in HDL-C at a significance level of 5%. Reductions in supine systolic/diastolic blood pressures were comparable in the two groups (carvedilol: 23/19 mmHg, captopril: 20/18 mmHg). The improvement in lipid metabolism in patients treated with carvedilol is probably due to its alpha 1-blocking properties.
我们在一项对照双盲、多中心、平行组试验中研究了250例轻度至中度原发性高血压（舒张压95 - 114 mmHg）和血脂异常（高密度脂蛋白胆固醇（HDL - C）低于1.03 mmol·l⁻¹，总胆固醇5.17 - 9.05 mmol·l⁻¹，甘油三酯2.26 - 5.64 mmol·l⁻¹）的患者。患者采用低脂饮食。经过4周的安慰剂期后，继续符合入选标准的患者被随机分配接受卡维地洛（一种血管舒张性β受体阻滞剂）25 - 50 mg每日一次（n = 116）或卡托普利（一种ACE抑制剂）25 - 50 mg每日一次（n = 117）治疗6个月。两组对血脂均有有益作用。卡维地洛组和卡托普利组的相对变化（中位数）分别为：HDL - C升高11%和8%，总胆固醇降低11%和10%，低密度脂蛋白胆固醇降低16%和12%，甘油三酯降低13%和14%。在5%的显著性水平下，证实了两种治疗方法在HDL - C目标变量变化方面具有等效性。两组仰卧位收缩压/舒张压的降低程度相当（卡维地洛组：23/19 mmHg，卡托普利组：20/18 mmHg）。用卡维地洛治疗的患者脂质代谢的改善可能归因于其α1阻断特性。
