Frohlich E D
Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121.
Am J Cardiol. 1987 Dec 14;60(17):3I-7I. doi: 10.1016/0002-9149(87)90451-6.
Systemic hypertension is a disease manifested by a persistently elevated arterial pressure produced by an increased total peripheral resistance, which is more or less uniformly distributed throughout the component circulations. Unless pressure is reduced and maintained at controlled levels, it will be associated with impaired function of the primary target organs of the disease: brain, heart, kidneys and blood vessels. The effects of an elevated arterial pressure on heart and kidneys and the effects of antihypertensive therapy on target-organ involvement will be discussed. Cardiac involvement primarily relates to left ventricular hypertrophy and its regression with treatment, and in the kidney to altered intrarenal hemodynamics and effects of treatment. The role of calcium antagonists, primarily diltiazem, is discussed with reference to its hemodynamic effects on reducing total peripheral resistance and arterial pressure associated with regression of ventricular hypertrophy and maintenance of renal blood flow without inordinately increasing glomerular hydrostatic pressure. Studies suggest a beneficial role of diltiazem in the treatment of essential hypertension.
系统性高血压是一种由于总外周阻力增加导致动脉压持续升高而表现出的疾病，这种外周阻力或多或少均匀分布于各个组成循环中。除非血压降低并维持在可控水平，否则它将与该疾病主要靶器官（脑、心脏、肾脏和血管）的功能受损相关。本文将讨论动脉压升高对心脏和肾脏的影响以及降压治疗对靶器官受累情况的影响。心脏受累主要与左心室肥厚及其治疗后的消退有关，而在肾脏方面则与肾内血流动力学改变及治疗效果有关。主要讨论钙拮抗剂（主要是地尔硫䓬）的作用，涉及它在降低总外周阻力和动脉压方面的血流动力学效应，以及与心室肥厚消退和肾血流维持相关的作用，同时不会过度增加肾小球静水压。研究表明地尔硫䓬在原发性高血压治疗中具有有益作用。
