Influence of anti-hypertensive therapy on serum cholesterol in elderly hypertensive patients. Results of trial by the European Working Party on High blood pressure in the Elderly (EWPHE).
Influence of anti-hypertensive therapy on serum cholesterol in elderly hypertensive patients. Results of trial by the European Working Party on High blood pressure in the Elderly (EWPHE).
复制标题
抗高血压治疗对老年高血压患者血清胆固醇的影响
作者：
A. Amery;W. Birkenhäger;C. Bulpitt;Denis Clement;M. Deruyttere;A. DeSchaepdryver;C. Dollery;R. Fagard;Françoise Forette;J. Forte;R. Hamdy;Gastone Leonetti;P. Lund;J. Macfarlane;A. Mutsers;Kevin O'Malley;Jaakko Tuomilehto
在欧洲老年人高血压工作组试验中，60岁以上的患者被随机分配接受含有25 mg氢氯噻嗪和50 mg氨苯蝶啶的利尿胶囊或匹配的安慰剂。如果血压仍然很高，那些接受积极利尿治疗的人也会接受甲基多巴。那些接受安慰剂利尿区给予安慰剂甲基多巴片。这项研究是双盲的，始于1974年，目前仍在进行中。331例患者已随访1年，其中190例随访2年，90例随访3年。1年后，安慰剂组的血清胆固醇平均下降10.4 mg/100 ml; 2年后下降16.0 mg/100 ml，3年后下降20.8 mg/100 ml（6.7%）。活性治疗组的相应结果为福尔斯：3.1 mg/100 ml; 20.3 mg/100 ml和17.3 mg/100 ml（6.6%）。在长达3年的时间内，安慰剂组胆固醇平均下降5.9 mg/100 ml/年，积极治疗组为5.0 mg/100 ml/年。因此，无论患者是否接受活性药物或安慰剂药物，血清胆固醇的变化相似。特别是，没有证据表明利尿剂治疗期间胆固醇升高或降低幅度较小。在积极治疗组中，高血压患者的血压下降伴随着血细胞比容和血清胆固醇的下降。在不太严重的高血压患者中，积极治疗并不伴随着红细胞压积或胆固醇的下降。这些不同的反应，血清胆固醇在更严重和更轻的高血压患者在本研究中可以解释一些以前的相互矛盾的报告利尿剂治疗对血清胆固醇的影响。
In the European Working Party trial on High blood pressure in the Elderly, patients over 60 are randomly allocated either to receive diuretic capsules containing 25 mg hydrochlorothiazide and 50 mg triamterene or matching placebos. If the blood pressure remains high those receiving active diuretic treatment also receive methyldopa. Those receiving a placebo diuretic area given placebo methyldopa tablets. The study is double blind, started in 1974 and is still in progress. Three hundred and thirty-one patients have now been followed for 1 year and of these 190 have been followed for 2 and 90 for 3 years. After 1 year the serum cholesterol in the placebo group fell by an average of 10.4 mg/100 ml; over 2 years the fall was 16.0 mg/100 ml and over 3 years 20.8 mg/100 ml (6.7%). The corresponding results for the actively treated group were falls of 3.1 mg/100 ml; 20.3 mg/100 ml and 17.3 mg/100 ml (6.6%). Over a period of up to 3 years the average fall in cholesterol was 5.9 mg/100 ml/year in the placebo group and 5.0 mg/100 ml/year in the actively treated group. Thus the changes in serum cholesterol were similar whether the patients received active or placebo medication. In particular there was no evidence for an increase in cholesterol nor for a smaller decrease during diuretic therapy. In the actively treated group the fall in blood pressure in the more hypertensive patients was accompanied by a fall both in haematocrit and serum cholesterol. In patients with less severe hypertension, active treatment was not accompanied by a fall in either hematocrit or cholesterol. These different responses of serum cholesterol in the more and less severe hypertensives in the present study could explain some of the previous conflicting reports on the influence of diuretic treatment on serum cholesterol.