摘要
背景中青年高血压的高患病率是我国重要公共卫生问题,这一人群高血压特征常常表现为舒张压明显升高。目的观察具有α受体阻断作用的β受体阻滞剂盐酸阿罗洛尔(阿尔马尔)与酒石酸美托洛尔(倍他乐克)对以舒张压升高为主的中青年高血压患者的降压疗效及糖脂代谢的影响。方法在14个临床研究医院选择舒张压升高为主的1～2级中青年原发性高血压患者,经1周洗脱期后随机分入盐酸阿罗洛尔或酒石酸美托洛尔治疗组,分别服用盐酸阿罗洛尔片剂5～10mg,2次/d或酒石酸美托洛尔片剂12.5～25.0mg,2次/d,治疗2周,如果血压未控制,坐位舒张压≥90mmHg和(或)坐位收缩压≥140mmHg,剂量分别调整到盐酸阿罗洛尔15mg,2次/d或酒石酸美托洛尔37.5mg,2次/d治疗至4周末。观察2种药物的降压疗效和耐受性。结果共完成随机试验合格病例277人,盐酸阿罗洛尔和酒石酸美托洛尔组分别为143例和134例。两组服药后2、4周末坐位收缩压和舒张压及心率与服药前比较均有明显降低(P<0.01);阿罗洛尔组4周末收缩压较美托洛尔组明显降低[阿罗洛尔组(135.4±9.4)比美托洛尔组(138.0±8.7)mmHg,P<0.05];阿罗洛尔组2周末、4周末舒张压下降均较酒石酸美托洛尔组显著[2周末,阿罗洛尔组(88.9±6.0)比美托洛尔组(92.0±5.9)mmHg,P<0.01;4周末,阿罗洛尔组(85.6±5.1)比美托洛尔组(88.8±5.2)mmHg,P<0.01]。治疗2周末、4周末舒张压下降幅度盐酸阿罗洛尔组较酒石酸美托洛尔组显著[2周末,阿罗洛尔组(8.8±5.2)比美托洛尔组(6.0±4.4)mmHg,P<0.01;4周末,阿罗洛尔组(11.9±6.4)比美托洛尔组(9.3±5.3)mmHg,P<0.01],阿罗洛尔较美托洛尔对于中青年高血压患者舒张压降压疗效更好。观察期内,盐酸阿罗洛尔对患者血糖、血脂及其他生化指标无不良影响,酒石酸美托洛尔轻度升高总胆固醇和三酰甘油。结论盐酸阿罗洛尔对于以舒张压升高为主的中青年高�
Background The high prevalence of hypertension in middle-aged patients,in which diastolic blood pressure often increases significantly,has become a major public health problem in China.Objective To compare the antihypertensive effects and safety profiles between arotinolol and metoprolol on middle-aged hypertensive patients with elevated diastolic blood pressure.Methods After 1 week wash-out period,middle-aged patients with essential hypertension seated diastolic blood pressure（SDBP）of 90-109 mm Hg and seated systolic blood pressure（SSBP）≤180 mm Hg ] were randomly assigned to either receive arotinolol 5-10 mg twice daily or metoprolol 12.5-25.0 mg twice daily for 2 weeks.By the end of 2 week treatment,if patients＇ SDBP were still over 90 mm Hg and（or）SSBP 140 mm Hg,they were treated with arotinolol 15 mg or metoprolol 37.5 mg twice daily for 2 more weeks.Seated blood pressure,heart rates,and adverse effects were taken and verified at the end of wash-out,2 and 4 weeks after treatment.Laboratory tests were ordered at baseline and at end of the trial.Results Two hundred seventy-seven eligible essential hypertensive patients from 14 centers were enrolled in trial,143 in arotinolol group and 134 in metoprolol group.By the end of 2 and 4 weeks,seated SBP and DBP were significantly reduced compared to at baseline（P 0.01）in both group,and there was a significant further reduction in SDBP in arotinolol group than in metoprolol group（8.8±5.2）vs（6.0±4.4）mm Hg,P 0.01;（11.9±6.4）vs（9.3± 5.3）mm Hg,P 0.01）] respectively.No severe adverse events were identified in either treatment group.Arotinolol had no influence
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2011年第2期163-166,共4页
Chinese Journal of Hypertension
