Bristow M R
Division of Cardiology, University Hospital, University of Colorado Health Sciences Center, Denver 80262, USA.
Cardiology. 1999;92 Suppl 1:3-6; discussion 7-9, 20-1. doi: 10.1159/000047287.
Hypertension is a major risk factor for the development of heart failure. Mechanisms which maintain normal function in the short term in the pressure overloaded heart have longer term deleterious effects. These include left ventricular (LV) hypertrophy and chronic activation of the adrenergic and renin-angiotensin systems. beta-Blocking agents are capable of blocking the adrenergic system and, to some extent, the renin-angiotensin system. They are therefore attractive in treating hypertension, both for preventing the development of abnormalities and for reversing established LV dysfunction and hypertrophy. Trials in heart failure have shown that these agents prevent progressive myocardial dysfunction, prevent and reverse remodelling and improve intrinsic systolic function. Non-selective beta-blocking agents appear to offer greater anti-adrenergic effects than selective ones. However, more research is needed, including direct comparisons of different agents.
高血压是心力衰竭发生的主要危险因素。在压力超负荷心脏中短期内维持正常功能的机制具有长期有害影响。这些包括左心室（LV）肥厚以及肾上腺素能和肾素 - 血管紧张素系统的慢性激活。β受体阻滞剂能够阻断肾上腺素能系统，并在一定程度上阻断肾素 - 血管紧张素系统。因此，它们在治疗高血压方面具有吸引力，既可以预防异常情况的发生，也可以逆转已有的左心室功能障碍和肥厚。心力衰竭试验表明，这些药物可预防进行性心肌功能障碍，预防和逆转重塑，并改善固有收缩功能。非选择性β受体阻滞剂似乎比选择性β受体阻滞剂具有更强的抗肾上腺素能作用。然而，还需要更多的研究，包括对不同药物的直接比较。
