贝凡洛尔治疗原发性高血压的疗效和安全性评价

Evaluation of the Efficacy and Safety of Bevantolol in Hypertension

目的 随机、开放、平行对照的比较评价两种选择性 β1受体阻断剂 (贝凡洛尔 美托洛尔 )治疗原发性高血压的疗效和安全性。方法 选择原发性高血压患者 136例 ,随机分为两组服用贝凡洛尔 10 0mg～ 2 0 0mg d或美托洛尔10 0mg～ 15 0mg d ,每日分二次治疗共 8周 ,根据需要 4周末调整剂量。分别比较两组药前、后第 2、4、6、8周末坐位血压和心率的变化。结果 口服盐酸贝凡洛尔 (10 0～ 2 0 0mg d ,分两次 )治疗原发性高血压 ,药后 2、4、6、8周平均SeDBP降低值分别为 8.9± 6 .4mmHg、7.9± 7.1mmHg、10 0± 8.2mmHg、11 0 0± 8.2mmHg ;平均SeSBP降低值分别为 8.8±11.4mmHg、10 6± 12 0mmHg、8.6± 14 .2mmHg、10 3± 14 .8mmHg。美托洛尔组 (10 0～ 15 0mg d ,分两次 )。药后 2、4、6、8周平均SeDBP降低值分别为 8.1± 9.2mmHg、7.7± 8.6mmHg、10 4± 7.9mmHg、10 7± 8.4mmHg ;平均SeSBP降低值分别为 7.1± 13.9mmHg、7.5± 13.3mmHg、10 9± 13.2mmHg、11.3± 13.9mmHg。服药前后降压值两组内比较均P =0 0 0 ,组间比较无统计学差异。贝凡洛尔单药治疗原发性高血压病患者 70 97%需要服用 2 0 0mg d。两组治疗后心率均较基线下降 ,贝凡洛尔组于治疗 4周后心率下降幅度有统计学差异 。

Objective To compare the clinical therapeutic efficacy and safety of two β 1 adrenoceptor antagonist (bevantolol and metoprolol) in the treatment of essential hypertension. Methods One hundred thirty six patients with hypertension were treated with bevantolol 100～200 mg/d or metoprolol 100～150 mg/d for 8 weeks randomly. BP and HR were examined 2, 4, 6, and 8 wks after treatment. Results At the end of the study, in bevantolol group, SBP were significantly decreased by 11 0±8.2 mmHg(-7.3%), DBP by 11 0±8.2 mmHg(-10 8%), while in metoprolol group SBP by 10 3±14.8 mmHg(-6.7%) and DBP by 11.3±13.9 mmHg(-11.3%). No differences in the magnitude of the reduction of SBP/DBP have been shown between the two groups. 71% patients in bevantolol group needed a daily dosage of 200 mg. HR was decreased significantly in both groups. The trend of decreasing HR was shown at 2～4 wks after the treatment and progressi obviously.\ Little changes in ECG were shown. The impact of bevantolol on metabolism (blood sugar. lipid) was not remarkable. The incidence of adverse effects in bevantolol group was 10 3% including headache, fatigue, dizziness, insomnia and increased in SGPT. All of them are mild with no patient withdrew from the study. Five patients in metoprolol group had sinus bradycardia, 1 sinus arrest; 2 of them discontinued the medication. Conclusion Bevantolol was effective and well tolerated in the treatment of hypertension.