Ruilope L
Department of Nephrology, Hospital 12 de Octobre, Madrid, Spain.
Blood Press Suppl. 2000;1:31-5.
Prognosis can be improved in hypertensive patients not only by reducing blood pressure, but probably also by effective suppression of adverse neurohormonal influences. Inhibition of the renin-angiotensin system by angiotensin-converting enzyme inhibitors effectively reduces left ventricular hypertrophy and decreases morbidity and mortality due to heart failure, as well as slowing the progression of renal disease. Initial data from studies of angiotensin II type 1 (AT1) receptor blockers indicate that these agents should also be effective in reducing cardiac and renal damage. In this class, candesartan, by virtue of its tight and long-lasting binding to the AT1-receptor, provides pronounced 24-h blood pressure control with effective blockade of all the major negative cardiovascular effects of angiotensin II. Candesartan cilexetil has also been shown to be effective and well tolerated in combination with hydrochlorothiazide in those hypertensive patients who require more than one agent to reach their target blood pressure.
高血压患者的预后不仅可以通过降低血压来改善，而且可能还可以通过有效抑制不良神经激素影响来改善。血管紧张素转换酶抑制剂对肾素-血管紧张素系统的抑制作用可有效减轻左心室肥厚，降低心力衰竭所致的发病率和死亡率，并减缓肾脏疾病的进展。1型血管紧张素II（AT1）受体阻滞剂的初步研究数据表明，这些药物在减少心脏和肾脏损害方面也应有效。在这类药物中，坎地沙坦因其与AT1受体紧密且持久的结合，可有效阻断血管紧张素II的所有主要负面心血管效应，从而实现显著的24小时血压控制。对于那些需要多种药物才能达到目标血压的高血压患者，坎地沙坦酯与氢氯噻嗪联合使用也已证明有效且耐受性良好。
