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氯噻酮治疗对系统性动脉高血压患者左心室质量降低的影响

[Effect of treatment with chlorthalidone on reduction of left ventricular mass in patients with systemic arterial hypertension].

作者信息

Ramires J A, Mansur A de P, Oigman W, Francischetti E, César L A, Marcondes M, da Luz P L, Pileggi F

机构信息

Instituto do Coração Hospital das Clínicas, FMUSP.

出版信息

Arq Bras Cardiol. 1993 Jun;60(6):433-5.

PMID:8279986
Abstract

PURPOSE

To evaluate the effects of the use of chlorthalidone on left ventricular mass of patients with mild and moderate systemic arterial hypertension (SAH).

METHODS

Twenty-nine patients with mild and moderate SAH were studied with mean age of 48.4 years and 16 men. Clinical evaluation, systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR), in supine and standing positions, were obtained before and every 3 weeks, after 2 with placebo, during 12 weeks of treatment with 50mg of chlorthalidone each 48 hours. Laboratory data (hemogram, sodium, potassium, urea creatinine, glucose, hepatic aminotransferases and urinalysis) were done before and at end of study. Echocardiographic study was performed by M-mode before and after 6 and 12 weeks of treatment, and obtained the following data: diastolic diameter (DdLV), diastolic septum (DSTLV) and posterior wall thickness (PWTLV) of left ventricle. The left ventricular mass (LVM) was calculated by the formula: LVM = (DSTLV+PWTLV+DdLVE)3 - (DdLV)3 x 1.05/body surface, in g/m2.

RESULTS

A significant reduction of SBP (p < 0.0001), DBP (p < 0.001) in supine and standing positions. HR did not show statistical difference. At echocardiographic study, M-mode, was observed a significant reduction of LVM after 12 weeks of treatment (181 +/- 67 to 156 +/- 34 g/m2, p < 0.01).

CONCLUSION

Chlorthalidone was effective to control blood pressure and to reduce LVM of patients with SAH.

摘要

目的

评估使用氯噻酮对轻中度系统性动脉高血压(SAH)患者左心室质量的影响。

方法

对29例轻中度SAH患者进行研究,平均年龄48.4岁,男性16例。在服用安慰剂2周后,每48小时服用50mg氯噻酮进行12周治疗期间,于治疗前及每3周获取仰卧位和站立位的临床评估、收缩压(SBP)、舒张压(DBP)和心率(HR)。在研究前及研究结束时进行实验室检查(血常规、钠、钾、尿素肌酐、葡萄糖、肝转氨酶和尿液分析)。在治疗6周和12周前后通过M型超声心动图进行研究,并获取以下数据:左心室舒张直径(DdLV)、舒张期室间隔(DSTLV)和后壁厚度(PWTLV)。左心室质量(LVM)通过以下公式计算:LVM =(DSTLV + PWTLV + DdLVE)3 -(DdLV)3×1.05/体表面积,单位为g/m2。

结果

仰卧位和站立位的SBP(p < 0.0001)、DBP(p < 0.001)显著降低。HR无统计学差异。在超声心动图研究的M型检查中,观察到治疗12周后LVM显著降低(从181±67降至156±34 g/m2,p < 0.01)。

结论

氯噻酮可有效控制SAH患者的血压并降低其LVM。

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