高血压:我们应该影响高血压的哪些方面以及如何影响?

Alberto Zanchetti, Bernard Waeber
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引用次数: 17

摘要

在很大程度上,可以通过降低高血压患者的血压来预防心血管并发症。目前,国际上的建议强调,每个患者的血压应低于140/90 mmHg,如果伴有糖尿病或肾功能损害,则应更低。目前认为控制收缩压和舒张压是至关重要的,特别是因为收缩压与血压之间的关系比舒张压更密切。收缩压升高本身就是动脉硬化的标志。在大多数患者中,只有联合使用几种不同的降压药才能达到目标血压。在STRATHE研究中,与基于单药治疗的其他治疗策略相比,采用固定低剂量的血管紧张素转换酶抑制剂(perindopril)和利尿剂(indapamide)联合治疗获得了更大的降压效果,特别是在收缩压方面。固定剂量抗高血压联合治疗现在已经成为一种有效的抗高血压治疗方案。
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Hypertension: which aspects of hypertension should we impact on and how?

Cardiovascular complications may, to a large extent, be prevented by lowering blood pressure in hypertensive patients. International recommendations currently stress the importance of reaching values of below 140/90 mmHg in each patient or even lower in the case of concomitant diabetes or renal impairment. It is currently considered crucial to control the systolic pressure as well as the diastolic pressure, in particular because the relationship between cardiovascular risk and blood pressure is closer for the systolic than the diastolic value. An increase in systolic pressure is in itself a sign of the stiffening of the arterial tree. In most patients, the target pressure may only be reached by combining several different antihypertensive agents. In the STRATHE Study, a greater antihypertensive efficacy, in particular on systolic pressure, was obtained by instituting treatment with a fixed low-dose combination of an angiotensin-converting enzyme inhibitor (perindopril) and a diuretic (indapamide), in comparison with other therapeutic strategies based on single-agent therapy. Fixed-dose antihypertensive combinations have now become a validated option for initiating antihypertensive treatment.

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