Barrios Vivencio
Department of Cardiology, Hospital Ramon y Cajal, Madrid, Spain.
Expert Rev Cardiovasc Ther. 2011 Nov;9(11):1375-82. doi: 10.1586/erc.11.144.
Treatment of patients with hypertension and ischemic heart disease should be focused not only on the control of overall cardiovascular risk factors, particularly blood pressure, but also on eliminating anginal symptoms, or at least reducing them, as angina symptoms have a crucial prognostic value. Although the amount of blood pressure reduction, rather than the choice of antihypertensive drug, is the major determinant of reduction of cardiovascular risk, some drugs such as ?-blockers should be preferably used in patients with angina. However, ?-blockers are contraindicated or produce intolerable side effects in many patients. Although, in the last years, new drugs for the treatment of stable angina have emerged, diltiazem should remain as a good alternative in the treatment of these patients. In this article, available evidence regarding diltiazem in the treatment of hypertension and ischemic heart disease is updated.
高血压和缺血性心脏病患者的治疗不仅应专注于控制整体心血管危险因素，特别是血压，还应致力于消除心绞痛症状，或至少减轻症状，因为心绞痛症状具有关键的预后价值。虽然血压降低的幅度而非抗高血压药物的选择是心血管风险降低的主要决定因素，但某些药物如β受体阻滞剂应优先用于心绞痛患者。然而，β受体阻滞剂在许多患者中是禁忌的或会产生无法耐受的副作用。尽管近年来出现了治疗稳定型心绞痛的新药，但地尔硫䓬仍应是治疗这些患者的良好选择。本文更新了有关地尔硫䓬治疗高血压和缺血性心脏病的现有证据。
