Chobanian A
Cardiovascular Institute, Boston University School of Medicine, MA 02118.
Am Heart J. 1988 Jul;116(1 Pt 2):319-22. doi: 10.1016/0002-8703(88)90108-1.
Many large-scale trials of drug treatment for hypertension have shown an apparent lack of benefit with regard to the incidence of complications related to atherosclerosis. Recent experimental evidence has contributed to an understanding of the pathogenesis of hypertensive vascular disease, although exact mechanisms by which hypertension and antihypertensive drugs influence the atherosclerotic process are still poorly defined. In animal models, hypertension appears to induce a sequence of changes in endothelial cells, smooth muscle cells, and endothelial permeability. However, increased lipid deposition in the intima and acceleration of atherosclerosis appear to require elevation of plasma lipid levels. Some beta-blockers have been found to retard the development of atherosclerosis in the cholesterol-fed rabbit model. The clinical applicability of these interesting research findings awaits further investigation.
许多大规模高血压药物治疗试验表明，在与动脉粥样硬化相关的并发症发生率方面，明显缺乏益处。尽管高血压和抗高血压药物影响动脉粥样硬化进程的确切机制仍不清楚，但最近的实验证据有助于人们理解高血压血管疾病的发病机制。在动物模型中，高血压似乎会在内皮细胞、平滑肌细胞和内皮通透性方面引发一系列变化。然而，内膜脂质沉积增加和动脉粥样硬化加速似乎需要血浆脂质水平升高。在喂食胆固醇的兔子模型中，已发现一些β受体阻滞剂可延缓动脉粥样硬化的发展。这些有趣研究结果的临床适用性有待进一步研究。
