高血压病降压治疗目的是将血压降至理想水平,延缓或逆转靶器官的损害,减少心血管病并发症的发生与死亡,在降压的同时能改善生活质量。一、概述一线降压药即理想或首选降压药,该药除达到上述要求外,还能逆转高血压特征性的血液动力学改...高血压病降压治疗目的是将血压降至理想水平,延缓或逆转靶器官的损害,减少心血管病并发症的发生与死亡,在降压的同时能改善生活质量。一、概述一线降压药即理想或首选降压药,该药除达到上述要求外,还能逆转高血压特征性的血液动力学改变即降低外周阻力、增加心排出量,又不影响压力感受器的反射机制,还能维持主要脏器的适当灌注压,半衰期长,最好一日或隔日一次,这样可大大增加服药的顺从性,副作用轻(包括对糖、脂肪等代谢的影响),易耐受。因此,如何选择理想的抗高血压药物是十分重要的。1978年 WHO 肯定了药物阶梯治疗高血压的方案。它纯是以临床经验为基础,始用单一药物。展开更多
Aims: Data on long-term efficacy of bosentan in unselected idiopathic pulmonary arterial hypertension(IPAH) patients are lacking. We aimed to describe the long-term outcome of consecutive IPAH patients treated first-l...Aims: Data on long-term efficacy of bosentan in unselected idiopathic pulmonary arterial hypertension(IPAH) patients are lacking. We aimed to describe the long-term outcome of consecutive IPAH patients treated first-line with bosentan. Methods and results: A retrospective analysis of 103 consecutive New York Heart Association functional class III/IV IPAH patients treated with bosentan at our centre between November 1999 and May 2004 was performed. The 6-minute walk distance(6MWD) and haemodynamics were assessed at baseline and after 4 and 12 months. Mean follow-up was 24±15 months. At 4 months, significant improvements in exercise capacity and haemodynamics were observed and persisted up to 1 year. Overall survival estimates were 90 and 87%and event-free status(survival without transplantation, prostanoid initiation, or hospitalization for right heart failure) estimates were 61 and 44%at 1 and 2 years, respectively. Forty-five(44%) patients required prostanoid therapy during follow-up. The 6MWD and the right atrial pressure at baseline and the 6MWD, the increase in 6MWD, and the decrease in pulmonary resistance after 4 months of treatment were associated with long-term outcomes. Conclusion: In our series of consecutive IPAH patients treated with bosentan, improvements in exercise capacity and haemodynamics were similar to those observed in previous randomized trials. However, on the basis of local criteria, many patients required the addition of prostanoid therapy during follow-up.展开更多
文摘高血压病降压治疗目的是将血压降至理想水平,延缓或逆转靶器官的损害,减少心血管病并发症的发生与死亡,在降压的同时能改善生活质量。一、概述一线降压药即理想或首选降压药,该药除达到上述要求外,还能逆转高血压特征性的血液动力学改变即降低外周阻力、增加心排出量,又不影响压力感受器的反射机制,还能维持主要脏器的适当灌注压,半衰期长,最好一日或隔日一次,这样可大大增加服药的顺从性,副作用轻(包括对糖、脂肪等代谢的影响),易耐受。因此,如何选择理想的抗高血压药物是十分重要的。1978年 WHO 肯定了药物阶梯治疗高血压的方案。它纯是以临床经验为基础,始用单一药物。
文摘Aims: Data on long-term efficacy of bosentan in unselected idiopathic pulmonary arterial hypertension(IPAH) patients are lacking. We aimed to describe the long-term outcome of consecutive IPAH patients treated first-line with bosentan. Methods and results: A retrospective analysis of 103 consecutive New York Heart Association functional class III/IV IPAH patients treated with bosentan at our centre between November 1999 and May 2004 was performed. The 6-minute walk distance(6MWD) and haemodynamics were assessed at baseline and after 4 and 12 months. Mean follow-up was 24±15 months. At 4 months, significant improvements in exercise capacity and haemodynamics were observed and persisted up to 1 year. Overall survival estimates were 90 and 87%and event-free status(survival without transplantation, prostanoid initiation, or hospitalization for right heart failure) estimates were 61 and 44%at 1 and 2 years, respectively. Forty-five(44%) patients required prostanoid therapy during follow-up. The 6MWD and the right atrial pressure at baseline and the 6MWD, the increase in 6MWD, and the decrease in pulmonary resistance after 4 months of treatment were associated with long-term outcomes. Conclusion: In our series of consecutive IPAH patients treated with bosentan, improvements in exercise capacity and haemodynamics were similar to those observed in previous randomized trials. However, on the basis of local criteria, many patients required the addition of prostanoid therapy during follow-up.
