β受体阻滞剂可降低接受血管紧张素转换酶抑制剂和利尿剂治疗患者的肾素水平。

Beta adrenergic blockers lower renin in patients treated with ACE inhibitors and diuretics.

作者信息

Holmer S R, Hense H W, Danser A H, Mayer B, Riegger G A, Schunkert H

机构信息

Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Germany.

出版信息

Heart. 1998 Jul;80(1):45-8. doi: 10.1136/hrt.80.1.45.

DOI:10.1136/hrt.80.1.45

PMID:9764058

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1728762/

Abstract

OBJECTIVE

To examine the effect of concomitant intake of beta blockers with angiotensin converting enzyme (ACE) inhibitors, diuretics, or both on plasma renin concentrations in a population based sample (MONICA survey, Augsburg, Germany).

SUBJECT AND METHODS

728 individuals were studied, of whom 171 were treated using monotherapy (ACE inhibitor (n = 21), diuretic (n = 10), or beta blocker (n = 72)), or combination treatment (ACE inhibitor + diuretic (n = 32), ACE inhibitor + beta blocker (n = 7), diuretic + beta blocker (n = 22), ACE inhibitor + diuretic + beta blocker (n = 7)). The remaining 557 individuals were untreated. Indications for treatment were hypertension (75%), coronary artery disease with (12%) or without (3%) hypertension, or unknown (10%).

RESULTS

Mean (SEM) renin concentrations in individuals treated with an ACE inhibitor (41 (8) mU/l), a diuretic (41 (10) mU/l), or the combination of an ACE inhibitor and a diuretic (54 (10) mU/l) were raised compared with untreated individuals (17 (1) mU/l; p < 0.05 each). Monotherapy with a beta blocker, however, decreased mean renin concentrations (12 (1) mU/l; p < 0.01 v untreated). Renin concentrations in individuals taking a beta blocker with either an ACE inhibitor (21 (8) mU/l), or a diuretic (22 (4) mU/l), or with both an ACE inhibitor and a diuretic (21 (7) mU/L), were significantly lower compared with renin concentrations in groups not receiving beta blocker treatment (p < 0.05 each).

CONCLUSION

These data suggest that the upregulation of renin by treatment with ACE inhibitors, diuretics, or both can be largely prevented by concomitant beta blocker treatment.

摘要

目的

在基于人群的样本中（德国奥格斯堡的莫尼卡调查），研究β受体阻滞剂与血管紧张素转换酶（ACE）抑制剂、利尿剂或二者联合使用对血浆肾素浓度的影响。

对象与方法

对728名个体进行了研究，其中171名接受单一疗法治疗（ACE抑制剂（n = 21）、利尿剂（n = 10）或β受体阻滞剂（n = 72）），或联合治疗（ACE抑制剂 + 利尿剂（n = 32）、ACE抑制剂 + β受体阻滞剂（n = 7）、利尿剂 + β受体阻滞剂（n = 22）、ACE抑制剂 + 利尿剂 + β受体阻滞剂（n = 7））。其余557名个体未接受治疗。治疗指征为高血压（75%）、伴有（12%）或不伴有（3%）高血压的冠状动脉疾病，或病因不明（10%）。

结果

与未接受治疗的个体（17（1）mU/l）相比，接受ACE抑制剂治疗的个体（41（8）mU/l）、接受利尿剂治疗的个体（41（10）mU/l）或接受ACE抑制剂与利尿剂联合治疗的个体（54（10）mU/l）的平均（标准误）肾素浓度升高（每组p < 0.05）。然而，单一使用β受体阻滞剂治疗可降低平均肾素浓度（12（1）mU/l；与未治疗个体相比p < 0.01）。与未接受β受体阻滞剂治疗组相比，同时服用β受体阻滞剂与ACE抑制剂（21（8）mU/l）、或与利尿剂（22（4）mU/l）、或与ACE抑制剂和利尿剂二者（21（7）mU/L）的个体的肾素浓度显著降低（每组p < 0.05）。