老年者高血圧に対するｃａｐｔｏｐｒｉｌとｃａｒｔｅｏｌｏｌの有効性と安全性

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タイトル別名
  • Antihypertensive treatment with captopril or carteolol in elderly patients.
  • ロウネンシャ コウケツアツ ニ タイスル captopril ト carteo

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To investigate the efficacy and safety of antihypertensive treatment with captopril (CAP) or carteolol (CAR) in elderly patients, 39 hypertensive patients over 60 years of age including 9 apoplectics and 7 diabetics were randomly allocated to either the CAP group (37.5mg/day) or the CAR group (15mg/day). Five cases dropped out. The mean age was 73.5 years in the CAP group and 71.9 years in the CAR group. Subjective symptoms were elicited by active questioning. Blood pressure was measured in a supine position and immediately after taking a standing position, using a COPALdigital sphygmomanometer. No significant differences were found between the CAP and CAR groups in supine systolic and diastolic blood pressures throughout the study. In CAP group, supine blood pressure significantly decreased from 186.2/96.9 to 161.0/88.1mmHg after 12 weeks of treatment, while in CAR group it also significantly decreased from 178.3/89.5 to 160.7/83.4mmHg. Systolic pressure changes on standing were -16.9 and -20.8mmHg before and 12 weeks after CAP treatment, respectively, whereas corresponding changes were -13.5 and -14.1mmHg in CAR treatment. Differences beteen CAP and CAR treatment groups and differences within both groups before and after treatment were not statistically significant. Serum creatinine levels were slightly but significantly increased in both treatment groups. The serum levels of total cholesterol, triglyceride, potassium and uric acid remained unchanged. Dopamine β-hydroxylase activities in serum significantly decreased in both groups. The number of cases complaining of black out on standing or dizziness did not increase. Congestive heart failure occurred in one case and wheezing in one case of CAR group, while one case of CAP group dropped out by the fall due to excessive decrease in blood pressure. It is concluded that treatment with either CAP or CAR is not only effective but also safe in elderly hypertensive as well as in younger ones if patients are under close observation.

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