Ebina Toshiaki, Kimura Kazuo, Umemura Satoshi
Division of Cardiology, Yokohama City University Medical Center, Japan.
Clin Calcium. 2010 Jan;20(1):16-22.
Japanese Society of Hypertension Committee published Guidelines for the Management of Hypertension in 2009 (JSH2009). The first choices of antihypertensive drugs are calcium channel blockers, angiotensin II receptor blockers, angiotensin converting enzyme inhibitors, diuretics, and beta-adrenergic blockers. Because dihydropyridine calcium channel blockers have the greatest hypotensive efficacy without affecting organ blood flow, they are indicated in the patients with complications and the aged. Positive indications of calcium channel blockers are left ventricular hypertrophy, tachycardia (non-dihydropyridine), angina pectoris, chronic phase of cerebrovascular disease, and elderly patients. Patients with bradycardia are contraindicated by non-dihydropyridine calcium channel blockers.
日本高血压学会委员会于2009年发布了《高血压管理指南》(JSH2009)。抗高血压药物的首选包括钙通道阻滞剂、血管紧张素II受体阻滞剂、血管紧张素转换酶抑制剂、利尿剂和β-肾上腺素能阻滞剂。由于二氢吡啶类钙通道阻滞剂在不影响器官血流的情况下具有最大的降压效果,因此适用于有并发症的患者和老年人。钙通道阻滞剂的阳性指征包括左心室肥厚、心动过速(非二氢吡啶类)、心绞痛、脑血管疾病慢性期以及老年患者。心动过缓患者禁用非二氢吡啶类钙通道阻滞剂。