Pedersen Ole Lederballe, Christensen Kent Lodberg, Bang Lia E, Ibsen Hans, Schultz-Larsen Peter
Medicinsk Afdeling, Regionshospitalet Viborg, DK-8800 Viborg.
Ugeskr Laeger. 2009 Jun 8;171(24):2022-5.
Drug therapy in uncomplicated hypertension can be initiated with either ACE-inhibitors, angiotensin II receptor antagonists, calcium channel blockers or thiazides. In younger patients, the first three classes are preferable. Beta-blockers are first-line drugs for hypertension in patients with cardiac comorbidity. Initial combination therapy is indicated in high-risk patients where blood pressure reduction of > 20/10 mmHg is desired. Resistant hypertension generally calls for an increment in diuretic dosage and/or addition of a potassium-sparing diuretic.
单纯性高血压的药物治疗可以从使用血管紧张素转换酶抑制剂、血管紧张素II受体拮抗剂、钙通道阻滞剂或噻嗪类利尿剂开始。对于较年轻的患者,前三类药物更为适用。β受体阻滞剂是有心脏合并症患者高血压的一线用药。对于期望血压降低幅度>20/10 mmHg的高危患者,建议采用初始联合治疗。顽固性高血压通常需要增加利尿剂剂量和/或加用保钾利尿剂。