高齢者難治性高血圧症患者におけるカルベジロールの血圧、血糖値、血中脂質に対する効果について

Effects of Carvedilol on Blood Pressure, Blood Sugar, and Blood Lipids in Elderly Patients with Refractory Hypertension.

抄録

難治性高血圧症は、患者の生命の安全に重大な影響を及ぼす。難治性高血圧の高齢者において、従来の降圧療法にカルベジロールを併用した場合の血圧、血糖、血中脂質、心血管・脳血管合併症に対する効果を検討するため、2019年6月から2021年9月に入院した難治性高血圧の高齢患者計80名をレトロスペクティブ研究対象として選び、乱数表法に従い、各群40例ずつ観察群と対照群に分け、対照群は従来の降圧療法を実施した。これをもとに、観察群にはカルベジロールを投与し、両群の血圧、血糖値、血中脂質、心血管・脳血管合併症の影響を分析した。治療後、観察群の収縮期血圧、拡張期血圧、副腎髄質（AM）、エンドセリン（ET）は対照群に比べ有意に低下したが、観察群の心拍数、NOは対照群に比べ有意に上昇した。投与後、観察群の空腹時血糖値、インスリン、トリアシルグリセロール（TG）、コレステロール（CHO）、低密度リポ蛋白（LDL-C）は対照群に比べ有意に高かったが、観察群のISIとHDL-Cは対照群に比べ有意に低値であった。治療後、観察群のIL-1、IL-6、TNF-、UAER、BUN、SCrは対照群に比べ有意に低値であった。また，観察群のTCは対照群より低値であった．併用療法は、難治性高血圧症患者に対して、顕著な安定性、持続性、安全性のある降圧効果を示す。

Refractory hypertension seriously affects the life safety of patients. To investigate the effect of carvedilol combined with conventional antihypertensive therapy on blood pressure, blood sugar, blood lipids, and cardiovascular and cerebrovascular complications in elderly patients with refractory hypertension, a total of 80 elderly patients with refractory hypertension who were admitted from June 2019 to September 2021 were selected as the retrospective research objects and divided into the observation group and the control group according to the random number table method, 40 cases in each group, and the control group received conventional antihypertensive therapy. On this basis, the observation group was treated with carvedilol, and the effects of blood pressure, blood sugar, blood lipids, and cardiovascular and cerebrovascular complications were analyzed in the two groups. After treatment, the systolic blood pressure, diastolic blood pressure, adrenal medulla (AM), and endothelin (ET) of the observation group were significantly lower than those of the control group, but the heart rate and NO of the observation group were significantly higher than those of the control group. After treatment, the fasting blood glucose, insulin, triacylglycerol (TG), cholesterol (CHO), and low-density lipoprotein (LDL-C) of the observation group were significantly higher than those of the control group, but the ISI and HDL-C of the observation group were significantly lower than those of the control group. After treatment, the levels of IL-1, IL-6, TNF-, UAER, BUN, and SCr in the observation group were significantly lower than those in the control group. The TC of the observation group was lower than that of the control group. Combination therapy has a remarkably stable, sustained, and safe antihypertensive effect on patients with refractory hypertension.