Edwards Elizabeth W, DiPette Donald J, Townsend Raymond R, Cohen Debbie L
Department of Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.
Renal, Electrolyte, and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
J Am Soc Hypertens. 2014 Jun;8(6):437-47. doi: 10.1016/j.jash.2014.03.333. Epub 2014 Apr 12.
The field of hypertension has evolved considerably over the last 70 years, from a belief that elevated blood pressure was an inevitable consequence of aging and beneficial, to maintaining perfusion to overwhelming proof of the cardiovascular morbidity and mortality associated with elevated blood pressure. The authors reviewed the literature on hypertension and selected 10 studies pivotal in changing physicians' attitudes regarding the management, treatment, and outcomes of hypertensive patients. Four studies cover treatment initiation and blood pressure goals, two studies compare pharmacologic antihypertensive agents, and the final four address the approach to blood pressure control in special populations (diabetes mellitus and chronic kidney disease). The authors readily acknowledge the many other contributions to the field of hypertension not profiled here.
在过去70年里,高血压领域发生了很大的演变,从认为血压升高是衰老的必然结果且有益(能维持灌注),到有压倒性证据表明血压升高与心血管疾病的发病率和死亡率相关。作者回顾了关于高血压的文献,并挑选了10项对改变医生对高血压患者管理、治疗及预后态度起到关键作用的研究。其中四项研究涉及治疗起始和血压目标,两项研究比较了抗高血压药物,最后四项研究探讨了特殊人群(糖尿病和慢性肾脏病)的血压控制方法。作者欣然承认,该领域还有许多其他贡献未在此处介绍。