Clinica Medica, Dipartimento di Medicina Clinica e Prevenzione, Università Milano, Milan, Italy.
Br Med Bull. 2010;94:189-99. doi: 10.1093/bmb/ldq004. Epub 2010 Feb 8.
Epidemiological studies have unequivocally shown that hypertension (HT)is a major cardiovascular (CV) risk factor and that a direct linear relationship exists between the severity of the blood pressure (BP) elevation and the occurrence of CV events.
The beneficial effects of the BP-lowering interventions have been recognized since a number of years. These include not only the reduction in CV morbidity and mortality but also the regression (or the delay of progression) of HT-related end-organ damage, such as left ventricular hypertrophy, vascular remodelling, endothelial dysfunction and renal damage. Along with these well-established features, antihypertensive drug treatment still faces a number of unmet goals and unanswered questions, such as the target BP values to achieve in high-risk patients, the threshold of treatment in low-risk patients as well as the choice of the therapeutic approach more likely to offer greater CV protection.
Despite unmet goals, antihypertensive treatment has provided throughout the years successful results. Future efforts will be need to achieve a better BP control in the population and thus to obtain a greater CV protection.
流行病学研究已经明确表明，高血压（HT）是心血管（CV）的主要风险因素，血压（BP）升高的严重程度与 CV 事件的发生之间存在直接的线性关系。
降低血压干预的益处已经得到了多年的认可。这些益处不仅包括降低 CV 发病率和死亡率，还包括与 HT 相关的靶器官损害的逆转（或进展延缓），如左心室肥厚、血管重塑、内皮功能障碍和肾脏损害。除了这些已被证实的特征外，降压药物治疗仍然面临着许多未满足的目标和未解决的问题，例如高危患者的目标血压值、低危患者的治疗阈值以及更有可能提供更大 CV 保护的治疗方法的选择。
尽管存在未满足的目标，但多年来降压治疗已经取得了成功的结果。未来需要努力在人群中实现更好的血压控制，从而获得更大的 CV 保护。
