Cleophas T J, van der Mey N, van der Meulen J, Niemeyer M G
Department of Medicine, Merwede Hospital Dordrecht, Netherlands.
Int J Clin Pharmacol Ther. 1996 Jul;34(7):312-7.
The well-being of hypertensive patients may be adversely affected by the disease itself, its complications, and other concomitant processes such as anxiety, sedation, and side effects of the prescribed drugs. Some recently developed antihypertensive agents have been suggested to be devoid of these deleterious effects on well-being expressed as quality of life.
We compared the effect on quality of life of a standard cardioselective beta-blocker atenolol to the effect of celiprolol as a representative of a new class of selective beta-blockers with vasodilatory properties. One-hundred-thirty-two patients with mild to moderate hypertension were eligible to enter a 28-week double-blind parallel-group study, consisting of a 4-week run-in period on placebo and a 24-week period on dosage-adjusted treatment with either atenolol or celiprolol.
Both systolic and diastolic blood pressure were assessed, as was quality of life perception by a selected test battery including the Quality of Life Questionnaire of Bulpitt and Fletcher [1990]. During celiprolol treatment, supine blood pressure fell from 167/101 (range 120-200/95-116) to 150/92 mm Hg (p < 0.0001). This antihypertensive effect was at least as good with celiprolol as with atenolol. Quality of life perception was comparable for the 2 drugs, although some adverse effects were more frequent during atenolol than during celiprolol, particularly after prolonged treatment. Also patient compliance was better for celiprolol than for atenolol.
Our results show that the selective beta-blocker with vasodilatory property celiprolol is at least as effective as atenolol and that it has additional advantage in terms of enhancement of some quality of life variables.
高血压患者的健康状况可能会受到疾病本身、其并发症以及其他伴随过程（如焦虑、镇静作用和所开药物的副作用）的不利影响。最近研发的一些抗高血压药物被认为对以生活质量表示的健康状况没有这些有害影响。
我们比较了标准心脏选择性β受体阻滞剂阿替洛尔与具有血管舒张特性的新型选择性β受体阻滞剂类代表药物塞利洛尔对生活质量的影响。132例轻度至中度高血压患者有资格参加一项为期28周的双盲平行组研究，该研究包括4周的安慰剂导入期和24周的阿替洛尔或塞利洛尔剂量调整治疗期。
评估了收缩压和舒张压，以及通过包括布尔皮特和弗莱彻生活质量问卷[1990]在内的选定测试组对生活质量的感知。在塞利洛尔治疗期间，仰卧位血压从167/101（范围120 - 200/95 - 116）降至150/92 mmHg（p < 0.0001）。塞利洛尔的这种抗高血压效果至少与阿替洛尔一样好。两种药物对生活质量的感知相当，尽管阿替洛尔治疗期间某些不良反应比塞利洛尔更频繁，尤其是在长期治疗后。而且塞利洛尔的患者依从性比阿替洛尔更好。
我们的结果表明，具有血管舒张特性的选择性β受体阻滞剂塞利洛尔至少与阿替洛尔一样有效，并且在改善某些生活质量变量方面具有额外优势。
