Lowenthal D T, Swartz C D
Prim Care. 1985 Mar;12(1):101-15.
The treatment of hypertension must be based on pathophysiologic grounds. The drugs that have been used in the classic stepped-care approach are still useful, but the rationale for their usage should not be based on the presumption that all hypertension is mediated by salt and water. Thus, the adolescent obtains greater benefits from a beta-adrenergic blocking drug or a centrally acting antihypertensive. The individual with heart failure may benefit more from a converting enzyme inhibitor than a vasodilator. In cerebrovascular disease with hypertension, dosage must be reduced owing to the enhanced sensitivity of response. New drugs are discussed, and their place in the armamentarium is evaluated.
高血压的治疗必须基于病理生理学依据。经典阶梯治疗法中使用的药物仍然有用，但其使用原理不应基于所有高血压均由盐和水介导的假设。因此，青少年使用β-肾上腺素能阻断药或中枢性抗高血压药可获得更大益处。心力衰竭患者使用转换酶抑制剂可能比使用血管扩张剂获益更多。对于伴有高血压的脑血管疾病患者，由于反应敏感性增强，必须减少用药剂量。本文讨论了新药，并评估了它们在药物库中的地位。
