Tomiyama Hirofumi, Yamashina Akira
Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Int J Hypertens. 2014;2014:919256. doi: 10.1155/2014/919256. Epub 2014 Jan 30.
This minireview provides current summaries of beta-blocker use in the management of hypertension and/or chronic kidney disease. Accumulated evidence suggests that atenolol is not sufficiently effective as a primary tool to treat hypertension. The less-than-adequate effect of beta-blockers in lowering the blood pressure and on vascular protection, and the unfavorable effects of these drugs, as compared to other antihypertensive agents, on the metabolic profile have been pointed out. On the other hand, in patients with chronic kidney disease, renin-angiotensin system blockers are the drugs of first choice for achieving the goal of renal protection. Recent studies have reported that vasodilatory beta-blockers have adequate antihypertensive efficacy and less harmful effects on the metabolic profile, and also exert beneficial effects on endothelial function and renal protection. However, there is still not sufficient evidence on the beneficial effects of the new beta-blockers.
本综述提供了β受体阻滞剂用于治疗高血压和/或慢性肾脏病的最新总结。累积证据表明,阿替洛尔作为治疗高血压的主要药物效果欠佳。与其他抗高血压药物相比,β受体阻滞剂在降低血压和血管保护方面效果欠佳,且这些药物对代谢状况有不利影响。另一方面,对于慢性肾脏病患者,肾素-血管紧张素系统阻滞剂是实现肾脏保护目标的首选药物。最近的研究报告称,血管舒张性β受体阻滞剂具有足够的降压疗效,对代谢状况的有害影响较小,并且对内皮功能和肾脏保护也有有益作用。然而,关于新型β受体阻滞剂的有益作用仍缺乏足够证据。