贝凡洛尔和美托洛尔对高血压病患者血脂代谢的影响

Effect of bevantolol and metoprolol on serum lipids in patients with essential hypertension

目的 :观察贝凡洛尔和美托洛尔对原发性高血压病患者血脂的影响。方法 :1 36例原发性高血压患者经 1周药物洗脱期 ,2周安慰剂后 ,随机服用贝凡洛尔 1 0 0mg·d- 1 ,bid(治疗组 ,n =68)或美托洛尔 50mg·d- 1 ,bid(对照组 ,n =68)。 4周末坐位舒张压 (SeDBP)≥ 1 2 .0 0kPa者剂量分别加至贝凡洛尔 2 0 0mg·d- 1 ,bid或美托洛尔75mg·d- 1 ,bid ,继续服用 4周。血压和心率每 2周测定 1次 ,血脂每 4周检查 1次。结果 :二药降低血压和心率的幅度相似 ,均对总胆固醇、高密度脂蛋白胆固醇无显著影响 (P =0 .30 )。但美托洛尔组三酰甘油比用药前明显升高[由 (1 .63± 0 .96)升至 (2 .1 5± 1 .53)mmol·L- 1 ] (P =0 .0 0 5)。用药 8周后与用药前差值的组间比较差异有一定差别 (P =0 .0 5)。贝凡洛尔组对三酰甘油水平无明显影响 [由 (1 .71± 1 .1 4 )升至 (1 .94± 1 .62 )mmol·L- 1 ] (P =0 .2 5)。结论 :新型 β 受体阻断剂贝凡洛尔与传统 β 受体阻断剂美托洛尔降压幅度相同时 ,贝凡洛尔对三酰甘油影响较小。

Objective:To investigate the effect of bevantolol and metoprolol on serum lipids in patients with essential hypertension.Methods:After 1 week wash out and 2 week placebo run in period,136 patients with essential hypertension were assigned randomly to receive bevantolol 50mg bid or metoprolol 50mg bid for 4 weeks,followed by dose titration to bevantolol 100mg,bid or metoprolol 75mg bid for another 4 weeks in those patients with distolic blood pressure ≥12.00kPa.The blood pressure and heart rate were measured every 2 weeks,and blood samples for evaluation of cholesterol (TC),HDL cholesterol (HDL C),triglycerides (TG) were taken every 4 weeks from active treatment.Results:Bevantolol and metoprolol caused similar blood pressure and heart rate reduction. Neither of the β blockers significantly affected TC and HDL C ( P =0.30).Metoprolol caused pronounced changes in TG[(1.63±0.96) to (2.15±1.53)mmol·L -1 ]( P =0.005).No similar changes [(1.71± [JP] 1.14) to (1.94±1.62)mmol·L -1 ] was found in bevantolol group( P =0.25). was found in bevantolol group( P =0.25).Conclusion:In similar blood pressure and heart rate reductions,bevantolol has less effect on triglycerides than metoprolol has.