Luque-Otero M, Fernandez-Pinilla C
Hypertension Unit, Hospital Universitario S. Carlos, Complutense University, Madrid, Spain.
Drugs. 1992;44 Suppl 1:56-60. doi: 10.2165/00003495-199200441-00010.
Even if the treatment goal in hypertension is 'the lower the better', it is obvious that blood pressure (BP) cannot be reduced without reaching a point at which organ perfusion may become compromised and where mortality and morbidity will increase rather than decrease. In 1979, a 5-fold increase in myocardial infarction among patients whose diastolic BP was reduced to below 95mm Hg was reported. In 1987, these results were confirmed, and a J-shaped relationship between diastolic BP and death from myocardial infarction in those patients with evidence of ischaemic heart disease at entry into the trial was shown. In recent years, several studies have demonstrated this J-shaped curve with a J-point between 85 and 91mm Hg. However, all the data were obtained in retrospective analyses of a small number of patients and prospective properly designed studies are necessary before changing our treatment criteria. The Behandla Blodtryck Battre Study fulfils these criteria and preliminary results demonstrate that it is possible to achieve a further reduction in BP in well controlled hypertensive patients without increasing the incidence of side effects.
即使高血压的治疗目标是“越低越好”，但很明显，如果血压（BP）降至可能影响器官灌注的程度，死亡率和发病率将增加而非降低，血压就无法再降低了。1979年，有报告称舒张压降至95mmHg以下的患者心肌梗死发生率增加了5倍。1987年，这些结果得到了证实，并且在试验开始时患有缺血性心脏病的患者中，舒张压与心肌梗死死亡之间呈现出J形关系。近年来，多项研究证实了这条J形曲线，J点在85至91mmHg之间。然而，所有数据均来自对少数患者的回顾性分析，在改变我们的治疗标准之前，有必要进行适当设计的前瞻性研究。Behandla Blodtryck Battre研究符合这些标准，初步结果表明，在控制良好的高血压患者中，有可能进一步降低血压而不增加副作用的发生率。
