Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Adv Ther. 2013 Apr;30(4):320-36. doi: 10.1007/s12325-013-0020-9. Epub 2013 Apr 3.
Hypertension is recognized as a major risk factor for cardiovascular and renal diseases and represents the leading cause of mortality worldwide. In spite of proven benefits of hypertension treatment, blood pressure control rates are poor, even in high-income countries with virtually full-access to therapies. Nearly 75% of hypertensive patients do not achieve adequate control with monotherapy, thus needing combination treatment. Strategies to improve blood pressure control include the prompt shift from monotherapy to combination therapy, the initial treatment with a two-drug combination, and the use of fixed-dose combinations in a single pill. Currently, preferred combinations include a renin-angiotensin blocker, either an angiotensin-converting enzyme inhibitor or an angiotensin-receptor blocker plus a calcium channel blocker or a diuretic. Some patients will also require a triple combination to achieve blood pressure control.
高血压被认为是心血管和肾脏疾病的主要危险因素，也是全球范围内主要的致死原因。尽管高血压治疗已被证实有益，但血压控制率仍然很差，即使在高收入国家，治疗方法几乎应有尽有。近 75%的高血压患者单药治疗无法充分控制血压，因此需要联合治疗。改善血压控制的策略包括：尽早将单药治疗转为联合治疗，起始即采用两药联合治疗，以及使用单片固定剂量复方制剂。目前，优选的联合治疗方案包括肾素-血管紧张素阻滞剂，即血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂，加用钙通道阻滞剂或利尿剂。一些患者还需要三联治疗才能控制血压。
