Department of Cardiology, University of Copenhagen, Denmark bHypertension Unit, Hospital 12 de Octubre, Rigshospitalet, Madrid, Spain.
J Hypertens. 2010 Aug;28(8):1595-8. doi: 10.1097/HJH.0b013e32833984b8.
An increasing number of patients in the community are being treated with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and beta-blockers for hypertension, coronary disease or diabetic renal and vascular complications. Some of these patients will develop heart failure despite such treatment. Based on data from hypertension trials it can be estimated that approximately 5% of treated patients will develop heart failure over 5 years. It is unclear whether patients developing heart failure on and off ACE-inhibitors or beta-blockers, respectively, at the time of heart failure diagnosis have similar prognosis.Treatment options for patients developing heart failure while already treated with ACE inhibitors/ARBs and beta-blockers are very limited if current heart failure guidelines are followed. In this review possible strategies are outlined and important areas for research are identified. It is suggested that trials are designed specifically to address prognosis and treatment in this growing population.
越来越多的社区患者正在接受血管紧张素转换酶（ACE）抑制剂、血管紧张素受体阻滞剂（ARB）和β-受体阻滞剂治疗高血压、冠心病或糖尿病肾脏和血管并发症。尽管进行了这种治疗，其中一些患者仍会出现心力衰竭。根据高血压试验的数据，可以估计大约 5%的治疗患者在 5 年内会发展为心力衰竭。尚不清楚在心力衰竭诊断时分别正在服用 ACE 抑制剂或β-受体阻滞剂的心力衰竭患者的预后是否相似。如果遵循当前的心力衰竭指南，那么对于已经接受 ACE 抑制剂/ARB 和β-受体阻滞剂治疗的心力衰竭患者，其治疗选择非常有限。在这篇综述中，概述了可能的策略，并确定了研究的重要领域。建议专门设计试验来解决这一不断增长的人群的预后和治疗问题。
