Mourad Jean-Jacques
Hypertension Unit, Avicenne, Hospital-AP-HP and Paris XIII, University Bobigny, 125 rue de Stalingrad, Bobigny, France.
Vasc Health Risk Manag. 2008;4(6):1315-25. doi: 10.2147/vhrm.s4073.
Elevated blood pressure is an important cardiovascular risk factor. Although targets for both diastolic blood pressure (DBP) and systolic blood pressure (SBP) are defined by current guidelines, DBP has historically taken precedence in hypertension management. However, there is strong evidence that SBP is superior to DBP as a predictor of cardiovascular events. Moreover, achieving control of SBP is assuming greater importance amongst an aging population. In spite of the growing recognition of the importance of SBP in reducing cardiovascular risk and the emphasis by current guidelines on SBP control, a substantial proportion of patients still fail to achieve SBP targets, and SBP control is achieved much less frequently than DBP control. Thus, new approaches to the management of hypertension are required in order to control SBP and minimize cardiovascular risk. Fixed-dose combination (FDC) therapy is an approach that offers the advantages of multiple drug administration and a reduction in regimen complexity that favors compliance. We have reviewed the latest evidence demonstrating the efficacy in targeting SBP of the most recent FDC products; combinations of the calcium channel blocker (CCB), amlodipine, with angiotensin receptor blockers (ARBs), valsartan or olmesartan. In addition, results from studies with new classes of agent are outlined.
血压升高是一个重要的心血管危险因素。尽管当前指南对舒张压（DBP）和收缩压（SBP）都设定了目标，但在高血压管理中，历史上DBP一直占据优先地位。然而，有强有力的证据表明，作为心血管事件的预测指标，SBP优于DBP。此外，在老龄化人群中，实现SBP控制变得越来越重要。尽管人们越来越认识到SBP在降低心血管风险方面的重要性，且当前指南也强调SBP控制，但仍有很大比例的患者未能达到SBP目标，而且实现SBP控制的频率远低于DBP控制。因此，需要新的高血压管理方法来控制SBP并将心血管风险降至最低。固定剂量复方（FDC）疗法是一种具有多种药物给药优势且能降低治疗方案复杂性从而有利于依从性的方法。我们回顾了最新证据，证明了最新FDC产品在靶向SBP方面的疗效；钙通道阻滞剂（CCB）氨氯地平与血管紧张素受体阻滞剂（ARB）缬沙坦或奥美沙坦的联合用药。此外，还概述了新型药物的研究结果。
