Waeber Bernard, de la Sierra Alejandro, Ruilope Luis M
Division of Clinical Pathophysiology, Centre Hospitalier Universitaire de Lausanne et Université de Lausanne, Lausanne, Switzerland.
J Hypertens Suppl. 2009 Jun;27(3):S13-8. doi: 10.1097/01.hjh.0000356767.24507.8d.
The early detection of cardiac organ damage in clinical practice is primordial for cardiovascular risk profiling of patients with hypertension. In this respect the determination of microalbuminuria is very appealing because it increasingly appears to be the most cost-effective means to identify cardiovascular and renal complications. Considering the treatment of patients with target organ damage, blockers of the renin-angiotensin system have a key position as they are very effective in regressing left ventricular hypertrophy, lowering urinary albumin excretion and delaying the progression of nephropathy. In high-risk patients with atherosclerosis, the use of a blocker of the renin-angiotensin system is also appealing, and it appears increasingly judicious to combine such a blocker with a calcium antagonist whenever required to control blood pressure.
在临床实践中，早期检测心脏器官损害对于高血压患者的心血管风险评估至关重要。在这方面，微量白蛋白尿的测定非常有吸引力，因为它越来越成为识别心血管和肾脏并发症最具成本效益的手段。考虑到对靶器官损害患者的治疗，肾素 - 血管紧张素系统阻滞剂具有关键地位，因为它们在逆转左心室肥厚、降低尿白蛋白排泄以及延缓肾病进展方面非常有效。在患有动脉粥样硬化的高危患者中，使用肾素 - 血管紧张素系统阻滞剂也很有吸引力，并且在需要控制血压时，将这种阻滞剂与钙拮抗剂联合使用似乎越来越明智。
