Ferrara L A, Di Marino L, Russo O, Marotta T, Mancini M
Institute of Internal Medicine and Metabolic Diseases, 2nd Medical School, University of Naples, Italy.
Hypertension. 1993 Jan;21(1):97-104. doi: 10.1161/01.hyp.21.1.97.
The evidence linking hypertension and hypercholesterolemia is strong and has fueled research into possible adverse effects of some antihypertensive agents on serum lipid profile. This multicenter, open, parallel study compares the effects of doxazosin and captopril on blood pressure, serum lipid levels, and quality of life in 224 hypercholesterolemic hypertensive patients. Blood pressure was significantly reduced in both treatment groups (p < 0.001) and was normalized (standing diastolic pressure < or = 90 mm Hg) in 73% of the doxazosin patients and 67% of the captopril group. Serum total cholesterol level was favorably reduced by both doxazosin (from 238 to 223 mg/dl, p < 0.001) and captopril (from 245 to 233 mg/dl, p < 0.001), whereas high density lipoprotein cholesterol concentration increased only in the doxazosin group (from 33 to 36 mg/dl, p < 0.001). The calculated 10-year risk for the development of coronary heart disease was reduced significantly (p < 0.001) by 28% in the doxazosin group and by 19% in the captopril group. The quality of life evaluation showed beneficial changes in both treatment groups. As a result of proven antihypertensive efficacy and a lack of unfavorable effects on lipid parameters and health status measures, these findings support the use of both doxazosin and captopril as agents of first choice in the treatment of hypertensive patients with associated lipid abnormalities.
将高血压与高胆固醇血症联系起来的证据很充分,这推动了对某些抗高血压药物可能对血清脂质谱产生的不良影响的研究。这项多中心、开放、平行的研究比较了多沙唑嗪和卡托普利对224例高胆固醇血症高血压患者的血压、血清脂质水平和生活质量的影响。两个治疗组的血压均显著降低(p<0.001),多沙唑嗪组73%的患者和卡托普利组67%的患者血压恢复正常(站立舒张压≤90mmHg)。多沙唑嗪(从238mg/dl降至223mg/dl,p<0.001)和卡托普利(从245mg/dl降至233mg/dl,p<0.001)均使血清总胆固醇水平得到了有利降低,而高密度脂蛋白胆固醇浓度仅在多沙唑嗪组有所升高(从33mg/dl升至36mg/dl,p<0.001)。多沙唑嗪组冠心病发生的计算10年风险显著降低(p<0.001)28%,卡托普利组降低19%。生活质量评估显示两个治疗组均有有益变化。由于已证实的抗高血压疗效以及对脂质参数和健康状况指标没有不利影响,这些研究结果支持将多沙唑嗪和卡托普利作为治疗伴有脂质异常的高血压患者的首选药物。