Scemama M, Février B, Beucler I, Dairou F
Institut de Recherches Internationales Servier, Courbevoie.
Ann Cardiol Angeiol (Paris). 1996 Dec;45(10):595-601.
Rilmenidine (dose of 1 mg once or twice a day) is the first oxazoline compound with antihypertensive properties. Its effects on lipid parameters [total cholesterol, HDL and LDL fractions, triglycerides, apolipoprotein A1 and B, lipoprotein (a)] were compared under double-blind conditions and in parallel groups to those of captopril (50 to 100 mg per day, in 2 divided doses) over a period of 8 weeks, in 51 hyperlipidaemic hypertensive patients [age: 56.3 +/- 1.5 years, systolic and diastolic blood pressure (SBP/DBP): 165.1 +/- 2.0/99.1 +/- 0.6 mmHg, LDL cholesterol: 5.38 +/- 0.16 mmol/L]. No significant difference was demonstrated between the groups on inclusion for any of the clinical parameters (SBP, DBP, heart rate (HR)) and laboratory parameters, apart from apolipoprotein A1, for which the mean value was higher in the rilmenidine group than in the captopril group (p < 0.05). No difference between the groups was demonstrated during the 8 weeks of treatment for the course of blood pressure: SBP and DBP decreased by 20.5 and 13.9 mmHg, respectively, in the rilmenidine group and by 21.3 and 13.1 mmHg in the captopril group (no significant difference: NS). HR decreased by 0.3 beats per minute (bpm) in the rilmenidine group and by 4.1 bpm in the captopril group (NS). No statistically significant difference in lipid parameters was observed between the two groups. No clinically significant variation in any of the lipid parameters was observed after 8 weeks of treatment with rilmenidine or captopril. These results confirm the antihypertensive efficacy and neutrality of rilmenidine on lipid metabolism over a period of 8 weeks. Rilmenidine therefore represents a useful alternative in the first-line treatment of hypertension in hyperlipidaemic hypertensive patients.
利美尼定(每日1毫克,一次或两次)是首个具有抗高血压特性的恶唑啉化合物。在双盲条件下,将51例高脂血症高血压患者(年龄:56.3±1.5岁,收缩压和舒张压[SBP/DBP]:165.1±2.0/99.1±0.6 mmHg,低密度脂蛋白胆固醇:5.38±0.16 mmol/L)分为平行组,比较了利美尼定与卡托普利(每日50至100毫克,分2次服用)在8周时间内对血脂参数[总胆固醇、高密度脂蛋白和低密度脂蛋白组分、甘油三酯、载脂蛋白A1和B、脂蛋白(a)]的影响。除载脂蛋白A1外,两组在纳入时的任何临床参数(SBP、DBP、心率[HR])和实验室参数均无显著差异,利美尼定组的载脂蛋白A1平均值高于卡托普利组(p<0.05)。在8周的治疗过程中,两组的血压变化无差异:利美尼定组SBP和DBP分别下降20.5和13.9 mmHg,卡托普利组分别下降21.3和13.1 mmHg(无显著差异:NS)。利美尼定组HR下降0.3次/分钟(bpm),卡托普利组下降4.1 bpm(NS)。两组血脂参数未观察到统计学上的显著差异。用利美尼定或卡托普利治疗8周后,任何血脂参数均未观察到具有临床意义的变化。这些结果证实了利美尼定在8周内的抗高血压疗效及其对脂质代谢的中性作用。因此,利美尼定是高脂血症高血压患者一线治疗的有用替代药物。