Middeke M
Hypertoniezentrum München, Excellence Centre of the European Society of Hypertension (ESH), Herzzentrum Alter Hof, Dienerstr. 12, 80331, München, Deutschland,
Internist (Berl). 2015 Mar;56(3):230-9. doi: 10.1007/s00108-014-3570-2.
Antihypertensive drug therapy is one of the most successful medical measures ever, at all levels. The treatment situation in Germany has clearly improved in recent years. Nowadays, a wide range of very effective and well-tolerated hypertensive substances is available. Combination therapy has a long and successful tradition in hypertensive treatment, especially with suitable fixed combinations. Furthermore, the administration of fixed combinations is very beneficial to therapy adherence because it is essentially dependent on the number of drugs to be taken. The value of beta blockers and the double blockade of the renin-angiotensin-aldosterone system are under discussion and the interpretation of corresponding studies must be conducted very carefully. The hypertensive effect of a substance cannot be comprehensively assessed without taking the time of day, the time point of measurement and the time point of intake into consideration. This is particularly important with respect to the effect over 24 h. Optimal antihypertensive therapy must also take into consideration the individual blood pressure rhythm with respect to the dose and dosing intervals. The importance of the central (aortic) blood pressure as target blood pressure will increase.
抗高血压药物治疗在各个层面都是有史以来最成功的医学措施之一。近年来，德国的治疗情况有了明显改善。如今，有多种非常有效且耐受性良好的降压药物可供使用。联合治疗在高血压治疗方面有着悠久且成功的传统，特别是使用合适的固定复方制剂。此外，服用固定复方制剂对治疗依从性非常有益，因为它基本上取决于需要服用的药物数量。β受体阻滞剂的价值以及肾素 - 血管紧张素 - 醛固酮系统的双重阻断正在讨论中，对相应研究的解读必须非常谨慎。如果不考虑一天中的时间、测量时间点和服药时间点，就无法全面评估一种药物的降压效果。这对于24小时的效果尤为重要。最佳的抗高血压治疗还必须根据剂量和给药间隔考虑个体血压节律。中心（主动脉）血压作为目标血压的重要性将会增加。
