Fursov A N, Potekhin N P, Orlov F A, Zakharova E G
Voen Med Zh. 2013 Jul;334(7):26-31.
In the early 20th century hypertension became a medical problem because of the prevalence. The process of clinical research of the etiopathogenesis of hypertension is associated with a scientific and technical progress and state of medical science at every historical stage. The first stage (end of the 19th century--beginning of the 20th (century) was characterised by a research of hypertension and monitoring of its natural history. The second stage (early--mid 20th century) was characterised by attempts to influence on the natural history of hypertension. The basis of the attempts was neurohumoral concept. The third stage (end of 50s--beginning of 70s)--was characterised by the application of angiotensin-converting enzyme inhibitor, calcium channel blocker and thiazide diuretic along with beta-adrenergic blockers. The fourth stage (end of 20th century--beginning of 21st) was characterised by discovery of the renin-angiotensin-aldosterone system, development of complex treatment options for hypertension, based on stratification of risk factors of cardiovascular complication. Clinical picture of hypertension haven't changed significally during the last 100 years. Cerebral and cardiac manifestations of hypertension remain dominat in 21st century as well as in 20th century. In the beginning of 21st century such systems as eyes and kidneys are not affected by the hypertension. Hypertension remains the main cause of progression of cardiac muscle and vessel wall structural changes.
在20世纪初,由于高血压的普遍存在,它成为了一个医学问题。高血压病因发病机制的临床研究过程与每个历史阶段的科学技术进步和医学科学状况相关。第一阶段(19世纪末 - 20世纪初)的特点是对高血压进行研究并监测其自然史。第二阶段(20世纪早期 - 中期)的特点是试图影响高血压的自然史,这些尝试的基础是神经体液概念。第三阶段(50年代末 - 70年代初)的特点是应用血管紧张素转换酶抑制剂、钙通道阻滞剂、噻嗪类利尿剂以及β - 肾上腺素能阻滞剂。第四阶段(20世纪末 - 21世纪初)的特点是发现肾素 - 血管紧张素 - 醛固酮系统,基于心血管并发症危险因素分层制定高血压的综合治疗方案。在过去的100年里,高血压的临床表现没有显著变化。高血压的脑部和心脏表现在21世纪和20世纪一样仍然占主导地位。在21世纪初,眼睛和肾脏等系统不受高血压影响。高血压仍然是心肌和血管壁结构变化进展的主要原因。