Chatzikyrkou Christos, Menne Jan, Haller Hermann
Abteilung für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Med Klin (Munich). 2009 Aug;104(8):614-21. doi: 10.1007/s00063-009-1133-4. Epub 2009 Aug 23.
Hypertension still represents a leading cause of mortality worldwide and a main modifiable risk factor for cardiovascular, cerebrovascular and renal diseases. Therefore, guideline writing groups have proposed new recommendations regarding diagnosis and treatment. Nevertheless, a series of large-scale clinical trials have been published thereafter. Their results, namely the risk associated with the combination of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), the benefits of an initial therapy with a fixed-dose combination of calcium channel blocker and ACE inhibitor, the effectiveness of blood pressure reduction in patients > 80 years, and the introduction of oral renin inhibitors in the market will enormously impact clinical practice.
高血压仍然是全球主要的死亡原因，也是心血管、脑血管和肾脏疾病的主要可改变风险因素。因此，指南编写小组提出了关于诊断和治疗的新建议。然而，此后一系列大规模临床试验已经发表。其结果，即血管紧张素转换酶（ACE）抑制剂与血管紧张素受体阻滞剂（ARB）联合使用的风险、钙通道阻滞剂与ACE抑制剂固定剂量联合初始治疗的益处、80岁以上患者血压降低的有效性以及口服肾素抑制剂在市场上的推出，将极大地影响临床实践。
