動脈硬化
Online ISSN : 2185-8284
Print ISSN : 0386-2682
ISSN-L : 0386-2682
高血圧症を合併した糖尿病患者に対するα・β-blocker, Arotinolol(Almarl®)の降圧効果および代謝に及ぼす影響の臨床的研究
三村 悟郎, 渡辺 清, 後藤 由夫, 奥口 文宜, 及川 眞一, 折茂 肇, 井藤 英喜, 河原 玲子, 川合 厚生, 田中 明, 堀内 光, 武越 裕, 平松 和子, 三国 龍彦, 高橋 壯一郎, 内田 健三, 小豆沢 定秀, 稲津 明広, 竹田 亮祐, 中井 継彦, 坂本 信夫, 吉見 輝也, 長谷川 晴彦, 三崎 盛治, 福井 巖, 橋本 眞徳, 松室 克義, 和田 成雄, 中埜 幸治, 河盛 隆造, 久保田 昌詞, 森島 豊彦, 馬場 茂明, 鹿住 敏, 藤井 隆, 芳野 原, 富長 将人, 亀山 和人, 島 健二, 石田 俊彦, 藤井 靖久
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1991 年 19 巻 12 号 p. 1111-1121

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In many cases with hypertension, diabetes and hyperlipidemia cause ischemic heart and cerebral diseases. In addition, hypertension is usually coupled with diabetes. Therefore, in diabetic patients whose condition has been complicated with hypertension, antihypertensive drugs should not only control blood pressure, but should also not adversely affect glucose and lipid metabolism. With this in mind, we studied the hypotensive effect of arotinolol, an α·β-blocker, and its effect on glucose and lipid metabolism.
206 patients in 56 hospitals received 20mg of arotinolol (Almarl®) twice a day for 24 weeks. The blood pressure and heart rate were measured every 2-4 weeks and fasted blood glucose (FBG), total cholesterol (T-Ch), triglyceride (TG), HDL-cholesterol (HDL-Ch), HbA1 and HbA1C were determined every 4 weeks.
The subjects were 206 diabetic patients with hypertension, 127 of which (=group A) received arotinolol only, and 79 of which (=group B) received a combined therapy with other antihypertensive drugs. The results were as follows.
1) Both in group A and B, arotinolol significantly reduced systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) after 2 weeks and thereafter. In group A the percentages of patients whose SBP and DBP recovered to normal levels (below 140mmHg and below 85mmHg respectively) were 33.6% and 53.6%, respectively.
2) Arotinolol also significantly decreased blood pressure in patients whose condition had been complicated with diabetic nephritis.
3) In terms of glucose metabolism, although arotinolol showed a tendency to slightly increase FBG, it did not significantly increase HbA1 and HbA1C.
4) Arotinolol did not significantly change T-Ch, TG and HDL-Ch.
5) Arotinolol produced no side-effects and was shown to be a safe drug.
On the basis of the results noted above, we concluded that arotinolol is a useful antihypertensive drug which does not adversely effect glucose and lipid metabolism in diabetic patients with hypertension.

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