Dujovne C A, Eff J, Ferraro L, Goldstein R J, Gotto A M, Hall W D, Harris W S, Held S J, Herd A, Hunninghake D B
Lipid and Arteriosclerosis Prevention Clinic, University of Kansas, Kansas City.
Am J Cardiol. 1993 Nov 15;72(15):1131-6. doi: 10.1016/0002-9149(93)90981-h.
Antihypertensive drugs may affect serum lipoprotein levels in mixed populations but data in hyperlipidemic patients are scanty. Atenolol versus celiprolol effects on serum lipoproteins were compared in 159 hyperlipoproteinemic hypertensive patients. This was a randomized, double-blind, parallel-group, positive-controlled multicenter trial with centralized lipoprotein laboratory and diet constancy monitoring. Blood pressure reduction and serum lipoprotein and apoprotein levels were monitored for 3 months. Both drugs reduced systolic and diastolic blood pressures. Atenolol had greater effects than celiprolol on diastolic pressure, but effects on systolic blood pressure were not different. Patients receiving atenolol had lower serum high-density lipoprotein cholesterol levels and higher low-density lipoprotein/high-density lipoprotein cholesterol ratios, whereas patients treated with celiprolol showed no contrasting changes. These differences in lipoprotein levels between drug treatment groups were statistically significant at weeks 9 and 12. The difference between drug treatments was also significant if the values of the 9- and 12-week visits were averaged. Patients taking atenolol had statistically significantly higher serum levels of total cholesterol, triglycerides and apoprotein B at 9 weeks. These divergent directional changes were consistent throughout and statistically significantly different between drugs.
抗高血压药物可能会影响混合人群的血清脂蛋白水平,但关于高脂血症患者的数据却很少。在159例高脂蛋白血症高血压患者中比较了阿替洛尔与塞利洛尔对血清脂蛋白的影响。这是一项随机、双盲、平行组、阳性对照的多中心试验,设有集中的脂蛋白实验室并进行饮食稳定性监测。对血压降低情况以及血清脂蛋白和载脂蛋白水平进行了3个月的监测。两种药物均降低了收缩压和舒张压。阿替洛尔对舒张压的影响大于塞利洛尔,但对收缩压的影响无差异。接受阿替洛尔治疗的患者血清高密度脂蛋白胆固醇水平较低,低密度脂蛋白/高密度脂蛋白胆固醇比值较高,而接受塞利洛尔治疗的患者则未出现相反变化。药物治疗组之间的这些脂蛋白水平差异在第9周和第12周具有统计学意义。如果将第9周和第12周就诊时的值进行平均,药物治疗之间的差异也很显著。服用阿替洛尔的患者在第9周时血清总胆固醇、甘油三酯和载脂蛋白B水平在统计学上显著更高。这些不同的方向性变化自始至终都是一致的,并且两种药物之间在统计学上有显著差异。