Nguyen K N
Institutt for farmakoterapi, Postboks, Blindern, Oslo.
Tidsskr Nor Laegeforen. 1993 Aug 30;113(20):2587-9.
Thiazide treatment is a first-line choice for hypersensitive patients: Thiazides have a flat dose-response as regards blood pressure, but induce biochemical changes only at higher doses. Given in low doses, which careful monitoring of potassium, thiazides provide adequate control of blood pressure without having any substantial impact on blood glucose. In high doses, thiazides may induce three to six new cases of impaired glucose tolerance per 1,000 patient years. The thiazide-induced changes in blood glucose can be prevented by giving lower doses and correcting hypokalaemia, and can be reversed by stopping the drug. In most diabetics, low doses of thiazides do not seem to diminish control of blood glucose. The well-documented effect of thiazides in reducing cardiovascular morbidity and mortality, their safety and their low price make them an excellent first-line choice for treatment of hypertension.
噻嗪类药物在血压方面具有平稳的剂量反应，但仅在高剂量时才会引起生化变化。低剂量给药时，在仔细监测血钾的情况下，噻嗪类药物可有效控制血压，而对血糖没有实质性影响。高剂量时，噻嗪类药物每1000患者年可能会导致3至6例新的糖耐量受损病例。通过给予较低剂量并纠正低钾血症可预防噻嗪类药物引起的血糖变化，停药后可逆转。在大多数糖尿病患者中，低剂量的噻嗪类药物似乎不会削弱血糖控制。噻嗪类药物在降低心血管发病率和死亡率方面的良好记录效果、安全性及低价格使其成为治疗高血压的极佳一线选择。
