ベータブロックベンドロフルアジドとプラゾシンによる重度の高血圧の評価
Lancet (London, England)
|February 5, 1977
まとめ
重度の高血圧の場合,ベータブロッカー療法にベンドロフルアジドまたはプラゾシンを加えると,血圧が著しく低下します. プラゾシンはわずかに大きな減少を示したが,ベンドロフルアジドはカリウムの低下を引き起こした.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- 重度の高血圧は,血圧を効果的にコントロールするために,多くの場合,複数の薬を必要とします.
- ベータブロッカーの単独療法では,一部の患者では,目標血圧を達成するのに不十分である可能性があります.
研究 の 目的:
- ベンドロフルアジドとプラゾシンの有効性を,重度の高血圧患者におけるベータブロッカーの追加療法として比較する.
- 初期追加療法が不十分である場合,三薬療法の安全性と有効性を評価する.
主な方法:
- 患者内でのランダム化クロスオーバー試験で,重度の高血圧を患っている20人の患者が参加した.
- 患者は,既存のベータブロッカー療法に加えて,ベンドロフルアジド (毎日5mg,その後10mg) またはプラゾシン (最大5mg3日) を投与された.
- 二重療法が不十分であった場合,患者のサブセットは3つの薬をすべて投与した.
主要な成果:
- ベータブロックにベンドロフルアジドを加えた結果,平均13%の平均血圧が低下した.
- ベータ・ブロックにプラゾシンを加えた結果,平均で平均血圧が16%低下した.
- 18人の患者が試験を終えた後,平均立体の血圧は139/93 mm Hgであった;プラゾシンは8人の患者でめまいを引き起こし,ベンドロフルアジドは半数の患者で低血圧を引き起こした.
結論:
- ベンドロフルアジド (5 mg) は,ベータブロッカーによって不十分に制御されたエッセンシャル高血圧の患者に有効な追加剤です.
- プラゾシン (Prazosin) は,重度の精性高血圧の管理のために,強力で適切な第三線剤です.
- 併用療法により,抵抗性の症例では,血圧を大幅に低下させることができます.
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