舒张性心力衰竭的高血压优化治疗

Optimal treatment of hypertension with diastolic heart failure.

作者信息

Susic Dinko, Frohlich Edward D

机构信息

Ochsner Clinic Foundation, New Orleans, LA 70121, USA.

出版信息

Heart Fail Clin. 2008 Jan;4(1):117-24. doi: 10.1016/j.hfc.2007.10.002.

DOI:10.1016/j.hfc.2007.10.002

PMID:18313629

Abstract

Approximately 5 million people in the United States have heart failure. Epidemiologic studies have demonstrated that at least one half of patients who have clinically overt heart failure have diastolic heart failure (DHF), or heart failure with preserved ejection fraction. DHF is characterized by concentric remodeling with normal left ventricular end-diastolic volume, abnormalities of active relaxation, and increased passive ventricular stiffness. Diuretics are an essential component of therapy for most patients who have DHF, and treatment of hypertension is a cornerstone of therapy designed to prevent or to treat DHF. Several antihypertensive agents have been shown to effectively reduce wave reflection, including angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium antagonists, and nitrates. Lifestyle changes may also be helpful.

摘要

美国约有500万人患有心力衰竭。流行病学研究表明，临床上出现明显心力衰竭的患者中，至少有一半患有舒张性心力衰竭（DHF），即射血分数保留的心力衰竭。DHF的特征是同心性重塑，左心室舒张末期容积正常，主动舒张异常，以及心室被动僵硬度增加。利尿剂是大多数DHF患者治疗的重要组成部分，治疗高血压是预防或治疗DHF的治疗基石。几种抗高血压药物已被证明能有效减少波反射，包括血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、钙拮抗剂和硝酸盐。生活方式的改变可能也有帮助。