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カレントテラピー　31-10　サンプル

74 Current Therapy 2013 Vol.31 No.101071Ⅳ ループ利尿薬ループ利尿薬はループオブヘンレの上行脚に作用し，Na＋，Cl-の再吸収を阻害する．ループ利尿薬は基本的に腎機能正常者では降圧薬として用いられない．尿細管中もっともNa＋の再吸収が起こる部位を阻害するが，生体のadaptationとしてより遠位ではむしろ再吸収が亢進することや短時間作用であることから持続的なNa利尿は起こらず，これが持続的な降圧が生じない理由のひとつかもしれない．サイアザイド系および類似利尿薬との違いを表4に示した．参考文献1）Freis ED, Wanko A, Wilson IM, et al：Treatment of essentialhypertension with chlorothiazide（diuril）；its use alone andcombined with other antihypertensive agents. J Am MedAssoc 166：137-140, 19582）Moser M, Macauley AI：Chlorothiazide as an adjunct in thetreatment of essential hypertension. Am J Cardiol 3：214-219, 19593）Veterans Cooperative Study Group on AntihypertensiveAgents：Effects of treatment on morbidity in hypertension：Results in patients with diastolic blood pressures averaging115 through 129 mm Hg. JAMA 202：1028-1034, 19674）ALLHAT Officers and Coordinators for the ALLHATCollaborative Research Group：Major outcomes in high-riskhypertensive patients randomized to angiotensin-convertingenzyme inhibitor or calcium channel blocker vs diuretic：The Antihypertensive and Lipid -Lowering Treatment toPrevent Heart Attack Trial（ALLHAT）. JAMA 288：2981-2997, 20025）SHEP Cooperative Research Group. Prevention of stroke byantihypertensive drug treatment in older persons with isolatedsystolic hypertension：final results of the SystolicHypertension in the Elderly Program（SHEP）. JAMA 265：3255-3264, 19916）Ernst ME, Moser M：Use of Diuretics in Patients withHypertension. N Engl J Med 361：2153-2164, 20097）Medical Research Council Working Party：Medical researchcouncil trial of treatment of hypertension in older adults：principal results. BMJ 304：405-412, 19928）Helgeland A：Treatment of mild hypertension：a five yearcontrolled drug trial?The Oslo Study. Am J Med 69：725-732, 19809）Amery A, Birkenhager W, Brixko P, et al：Mortality andmorbidity results from the European Working Party on HighBlood Pressure in the Elderly trial. Lancet 1：1349-1354,198510）PATS Collaborating Group：Post -stroke antihypertensivetreatment study. A preliminary result. Chin Med J（Engl）108：710-717, 199511）Beckett NS, Peters R, Fletcher AE, et al：HYVET studygroup：Treatment of hypertension in patients 80 years ofage or older. N Engl J Med 358：1887-1898, 200812）Multiple Risk Factor Intervention Trial Research Group：Mortality after 10 1/2 years for hypertensive participants inthe Multiple Risk Factor Intervention Trial. Circulation 82：1616-1628, 199013）Brown MJ, Palmer CR, Castaigne A, et al：Morbidity andmortality in patients randomised to double-blind treatmentwith a long-acting calcium-channel blocker or diuretic inthe International Nifedipine GITS study：Intervention as aGoal in Hypertension Treatment（INSIGHT）. Lancet 356：366-372, 200014）Wing LM, Reid CM, Ryan P, et al：Second AustralianNational Blood Pressure Study Group：A comparison of outcomeswith angiotensin-converting?enzyme inhibitors anddiuretics for hypertension in the elderly. N Engl J Med 348：583-592, 200315）Jamerson K, Weber MA, Bakris GL, et al；ACCOMPLISHTrial Investigators：Benazepril plus amlodipine or hydrochlorothiazidefor hypertension in high-risk patients. N EnglJ Med 359：2417-2428, 200816）Ernst ME, Carter BL, Goerdt CJ, et al：Comparative antihypertensiveeffects of hydrochlorothiazide and chlorthalidoneon ambulatory and office blood pressure. Hypertension 47：352-358, 200617）Woodman R, Brown C, Lockette W：Chlorthalidone decreasesplatelet aggregation and vascular permeability and promotesangiogenesis. Hypertension 56：463-470, 201018）Kurtz TW：Chlorthalidone：Don’t Call It "Thiazide-Like"Anymore. Hypertension 56：335-337, 201019）Chapman N, Dobson J, Wilson S, et al；Anglo-ScandinavianCardiac Outcomes Trial Investigators：Effect of spironolactoneon blood pressure in subjects with resistant hypertension.Hypertension 49：839-845, 2007