Hansson L
Department of Medicine, University of Göteborg, Sweden.
J Cardiovasc Pharmacol. 1989;14 Suppl 7:S1-3.
Today, beta-blockers are frequently the drugs of first choice for the treatment of hypertension. It had been hoped that beta-blocker therapy would confer a primary preventive effect against coronary artery disease (CAD), but so far a positive effect has been shown only in open trials. In addition to a primary preventive effect (which remains to be shown in a controlled trial), it is anticipated that in the future treatment of hypertension the bea-blockers will have vascular protective potential. The regression of hypertension-induced structural arteriolar changes has already been demonstrated when a vasodilating component is present, while in experimental animals subjected to stress and a high cholesterol intake beta-blockers prevent or reduce the degree of coronary atheromatosis. For such reasons it seems logical to predict that beta-blockers, especially those with a vasodilating action, afford potential cardiovascular protection. Thus, in addition to their antihypertensive effects, regression of cardiovascular hypertrophic changes can be expected, presumably with a primary preventive action against CAD and atherosclerotic changes. Clinical trials to evaluate these highly desirable prospects should be given high priority.
如今，β受体阻滞剂常常是治疗高血压的首选药物。人们曾希望β受体阻滞剂疗法能对冠状动脉疾病（CAD）起到一级预防作用，但迄今为止，仅在开放试验中显示出了积极效果。除了一级预防作用（仍有待在对照试验中证实）之外，预计在未来高血压治疗中，β受体阻滞剂将具有血管保护潜力。当存在血管舒张成分时，高血压引起的小动脉结构变化的消退已经得到证实，而在遭受应激和高胆固醇摄入的实验动物中，β受体阻滞剂可预防或减轻冠状动脉粥样硬化的程度。基于这些原因，预测β受体阻滞剂，尤其是那些具有血管舒张作用的β受体阻滞剂具有潜在的心血管保护作用似乎是合理的。因此，除了其降压作用外，可以预期心血管肥厚性变化会消退，大概对CAD和动脉粥样硬化变化具有一级预防作用。评估这些极具吸引力前景的临床试验应被高度重视。
