Soucek M
II. interní klinika Lékarské fakulty MU a FN u sv. Anny Brno.
Vnitr Lek. 2009 Sep;55(9):719-23.
Target blood pressure levels are not being achieved with the current hypertension treatment. Monotherapy that normalizes BP in about 20% of patients does not provide sufficient control to reach this goal and thus combination therapy is required. Results from recent clinical studies showed that a combination of an angiotenzin-converting enzyme inhibitor (ACEi) with a calcium channel blocker (CCB) provide better results and reduced incidence of cardiovascular events than a combination of a diuretic with an ACE inhibitor. Combination therapy based on rennin-angiotenzin system blockade: ACEi with a CCB, ACEi with a diuretic or angiotenzin receptor blocker (AT1) with a diuretic as a first-line treatment of the stage 2 hypertension might lead to significantly better control of blood pressure than monotherapy.
目前的高血压治疗方案未能达到目标血压水平。单药治疗仅能使约20%的患者血压正常化，无法充分控制血压以实现这一目标，因此需要联合治疗。近期临床研究结果表明，与利尿剂和ACE抑制剂联合治疗相比，血管紧张素转换酶抑制剂（ACEi）与钙通道阻滞剂（CCB）联合使用能取得更好的效果，并降低心血管事件的发生率。基于肾素-血管紧张素系统阻断的联合治疗：ACEi与CCB联合、ACEi与利尿剂联合或血管紧张素受体阻滞剂（AT1）与利尿剂联合作为2级高血压的一线治疗，可能比单药治疗能显著更好地控制血压。
