Houston Miller Nancy
Stanford Cardiac Rehabilitation Program, 703 Welch Road, Suite F1, Palo Alto, CA 94304, USA.
Nurs Res Pract. 2010;2010:101749. doi: 10.1155/2010/101749. Epub 2010 Aug 12.
This paper examines the evidence supporting treatments within the renin-angiotensin aldosterone system (RAS), the role cardioprotection plays within the management of hypertension, considerations around medication adherence, and the role of the nurse or nurse practitioner in guiding patients to achieve higher hypertension control rates. A large body of data now exists to support the use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) which act on RAS, in the management of hypertension and their effect on cardiovascular risk reduction. Current evidence suggests that inhibition of the RAS is an important target for cardioprotection. RAS inhibition controls blood pressure and also reduces target-organ damage. This is especially important in populations at high-risk for damage including patients with diabetes and those with chronic kidney disease. Both ARBs and ACEIs target the RAS offering important reductions in both BP and target organ damage.
本文探讨了支持肾素-血管紧张素-醛固酮系统(RAS)内治疗方法的证据、心脏保护在高血压管理中的作用、关于药物依从性的考量以及护士或执业护士在指导患者实现更高高血压控制率方面的作用。现在有大量数据支持使用作用于RAS的血管紧张素受体阻滞剂(ARB)和血管紧张素转换酶抑制剂(ACEI)来管理高血压及其对降低心血管风险的作用。当前证据表明,抑制RAS是心脏保护的一个重要靶点。RAS抑制可控制血压并减少靶器官损伤。这在包括糖尿病患者和慢性肾病患者在内的高风险损伤人群中尤为重要。ARB和ACEI均作用于RAS,在降低血压和靶器官损伤方面均有重要作用。