Nickey W A
Division of Nephrology and Hypertension, Philadelphia College of Osteopathic Medicine, PA 19131-1696.
J Am Osteopath Assoc. 1990 Dec;90(12):1085-91.
Traditionally, diuretics have been the only agents considered appropriate for initial antihypertensive treatment, and other drugs have been added sequentially. Diuretics may cause a number of adverse metabolic effects as well as a decrease in the quality of life for some patients. Currently, physicians are modifying their approach to treating hypertension and using alternatives to diuretics as initial therapy. Diuretics are often used in combination with many of the newer antihypertensive drugs. Some antihypertensive agents, such as the angiotensin-converting enzyme inhibitors, may blunt the adverse metabolic effects of the diuretics with which they are combined. This review discusses the advantages and disadvantages of beta-adrenergic blocking agents, calcium-channel blockers, and alpha-adrenergic blocking agents.
传统上，利尿剂一直是唯一被认为适合作为初始抗高血压治疗的药物，其他药物则依次添加。利尿剂可能会引起一些不良代谢效应，并且会降低一些患者的生活质量。目前，医生们正在改变他们治疗高血压的方法，并使用利尿剂以外的药物作为初始治疗。利尿剂经常与许多新型抗高血压药物联合使用。一些抗高血压药物，如血管紧张素转换酶抑制剂，可能会减轻与其联合使用的利尿剂的不良代谢效应。本综述讨论了β-肾上腺素能阻滞剂、钙通道阻滞剂和α-肾上腺素能阻滞剂的优缺点。
