Effects of Doxazosin on the Serum Lipid and Coronary Risk Score in Chinese Patients with Mild to Moderate Hypertension

Abstract

Doxazosin, a long-acting selective α1-adrenoceptor inhibitor, was assessed for its antihypertensive efficacy, safety and effect on lipid parameters and coronary risk score in 20 Chinese patients with essential hypertension. They were 7 males and 13 females, aged from 32 to 67 (mean 51.0) years. The study involved a 2-week baseline period, and a 10-week active treatment period in which patients received doxazosin 1 to 8 mg once daily. The mean sitting blood pressure was significantly reduced(P<0 .0001) by 18.8/ 13.3 mmHg at final visit with a mean dose of 3.6 mg once daily. Four patients (20﹪) reported side effects including dizziness in four, headache in two and insomnia in one, but symptoms were transient and not severe. No patient required dose reduction or discontinuation of therapy because of side effects. Triglyceride level was significantly reduced (P<0.05). Total cholesterol levels showed a decreasing trend and high density lipoprotein cholesterol (HDL-C) levels showed an increasing trend, but without statistical significance (P>0.05). From baseline to final visit, there was a highly significant, 49﹪(P<0.005) reduction in calculated coronary heart disease risk score, on the basis used in the Framingham study. It was concluded that doxazosin once daily is an effective and safe regimen for Chinese patients with mild to moderate hypertension. It might also be beneficial for reducing coronary risk in these patients. 為瞭解長效性α1交感神經抑制劑Doxazosin之降血壓效果、安全性 及其對血中脂質與冠狀動脈危險分數之影響，著者等針對20位本態性高血壓病人進行 試用研究，其中男性 7人，女性13人，年齡在32至67歲之間（平均51歲）。試用期間 包括 2週之觀察期及10週之治療期，（每天使用1至8毫克doxazosin ），在試用前後 測量血壓、心跳、血液相、血液生化及心電圖檢查，詢問副作用之有無，並計算其冠 狀動脈危險分數。結果如下：所有病人平均使用Doxazosin 3.6 mg/day，可有效降低 坐姿血壓達 18.8/13.3 mmHg (P <0.0001) ；雖然有四位病人有頭暈、頭疼與失眠等 副作用，但均不厲害且自行消失；並無病人因副作用而停藥者。血中三酸甘油酯濃度 有意義地降低(P<0.05)；而膽固醇總量有降低傾向、高密度脂蛋白量有升高傾高，但 均未達統計學意義(P>0.05)。至於冠狀動脈危險分數則用藥後下降49﹪之多(P<0.005 ) 。因此我們認為每天一次Doxazosin 為一安全有效之降血壓藥劑，它可能對冠狀動 脈疾病有益。#A1493057