高血压研究进展

Research Progress in Hypertension

JNC7强调 :高血压必须积极治疗。联合降压、保护靶器官为核心治疗 ,二者并重原则。在 6大类抗高血压药推荐强适应证时 ,血管紧张素转换酶抑制剂 (ACEI)是唯一拥有全部 6个强适应证的首选药物 ;噻嗪类利尿剂强适应证为心力衰竭 (HF)、冠心病 (CHD)高危险、糖尿病 (DM )和预防脑卒中再发 ;血管紧张素受体拮抗剂 (ARB)用于HF、DM和慢性肾病患者 ;β 肾上腺素受体拮抗剂 (β AA)用于HF、心肌梗死 (MI)后、CHD高危险、DM患者 ;钙通道阻滞剂 (CCB)用于CHD高危险、DM患者以及醛固酮拮抗剂拥有HF、MI后的高血压患者二个强适应证。近年主张合用他汀类药可显著降低MI和脑卒中率。

JNC-7 emphasis hypertension must be initiatively tr eated .Combining antihypertensive and protecting target organ is the key treatme nt.Both are important.ACEI(angiotensin-converting enzyme inhibitors)is always the first elected because it is the only one that has all six powerful adaptat ion. Thiazide diuretic powerful adaptation is heart failure( HF),coronary heart disease (CHD),diabetes mellitus(DM)and prevented cerebral stroke relapse,and an giotensin Ⅱ receptor blockade (ARB)is used for HF,DM, and chronic nephropathy. Beta adrenoceptor antagonist(β-AA)is used for patients with HF,MI,CHD and DM ,calcium channel blockade( CCB)is used for CHD and DM and aldosterone antagonis t is used for HF and MI.Recently ,combining HmG-CoA reductose inhibitors is sug gested,because it can decreases the MI rate and cerebral stroke.