Laganović Mario
Klinika za unutrasnje bolesti, Medicinskog fakulteta u Zagrebu, KBC Zagreb.
Lijec Vjesn. 2010 Mar-Apr;132(3-4):94-8.
Arterial hypertension is one of the major public health problems. Early recognition and treatment, based on total cardiovascular risk assessment, is crucial for cardiovascular and renal protection. The choice of initial drug is often futile because most of hypertensive patients will need more than one medication for achieving blood pressure control. Initiation of treatment wih combination of antihypertensive drugs is reasonable choice especially in high or very high risk patients where it is important to achieve prompt and intensive blood pressure control in order to reduce cardiovascular complications. Fixed combination of two antihypertensive drugs can simplify treatment and favour compliance. The last, 2007 ESH/ESC guidelines, and several studies published in the meantime, favour use of ACE inhibitors or angiotensin receptor blockers with calcium channel blockers or diuretics as the combination of choice. Fixed combination of ramipril and felodipine is in agreement with guidelines recomendations with proven benefit on cardiovascular protection and non-diabetic kidney disease in patients with essential hypertension.
动脉高血压是主要的公共卫生问题之一。基于总体心血管风险评估的早期识别和治疗对于心血管和肾脏保护至关重要。初始药物的选择往往徒劳无功，因为大多数高血压患者需要不止一种药物来控制血压。联合使用抗高血压药物开始治疗是合理的选择，尤其是在高危或极高危患者中，为了减少心血管并发症，迅速而强化地控制血压非常重要。两种抗高血压药物的固定复方制剂可以简化治疗并有助于提高依从性。最新的2007年ESH/ESC指南以及其间发表的多项研究都支持将ACE抑制剂或血管紧张素受体阻滞剂与钙通道阻滞剂或利尿剂联合使用作为首选组合。雷米普利和非洛地平的固定复方制剂符合指南建议，已证实对原发性高血压患者的心血管保护和非糖尿病肾病有益。
