Manu Peter, Rogozea Liliana M, Ivanescu-Lint Andreea, Dan Gheorghe Andrei
Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Basic, Preventive and Clinical Sciences Department, Transilvania University, Brasov, Romania; and.
Am J Ther. 2022;29(3):e287-e297. doi: 10.1097/MJT.0000000000001505.
Advances in drug therapy for primary (or essential) arterial hypertension have contributed to a significant decrease in the frequency and severity of strokes, coronary artery disease and heart failure, and chronic renal insufficiency.
What are the milestones of the changes in the expert approach to the pharmacological management of arterial hypertension in the past century?
To determine the changes in the experts' approach to the management of arterial hypertension, as presented in a widely used textbook in the United States.
The chapters presenting the management of arterial hypertension in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020.
The pharmacological management of arterial hypertension has had 3 overlapping eras in the timeframe subject to our investigation. In the empiric era (1927-1947), experts were recommending nonspecific interventions for sedation. The premodern era (1955-1963) relied on ganglion blockers, sympathetic blockers, and direct vasodilators. The modern era (1967-2020), which includes drugs used in current clinical practice, saw the introduction of diuretics (1967), beta-blockers (1971), alpha-blockers (1982), calcium channel blockers (1985), angiotensin-converting enzyme inhibitors (1985), angiotensin receptor blockers (2000), and direct renin inhibitors (2008).
The pharmacological management of arterial hypertension has been the focus of intense and successful research and development in the second half of the 20th century.
原发性（或特发性）动脉高血压药物治疗的进展已使中风、冠状动脉疾病、心力衰竭和慢性肾功能不全的发生率及严重程度显著降低。
在过去一个世纪中，专家对动脉高血压药物治疗方法的改变有哪些里程碑？
为了确定专家对动脉高血压治疗方法的改变，这在一本美国广泛使用的教科书中有所呈现。
1927年至2020年出版的《西塞尔内科学》26个版本中有关动脉高血压治疗的章节。
在我们所研究的时间范围内，动脉高血压的药物治疗经历了3个重叠的时代。在经验时代（1927 - 1947年），专家推荐使用非特异性镇静干预措施。前现代时代（1955 - 1963年）依赖神经节阻滞剂、交感神经阻滞剂和直接血管扩张剂。现代时代（1967 - 2020年），包括当前临床实践中使用的药物，见证了利尿剂（1967年）、β受体阻滞剂（1971年）、α受体阻滞剂（1982年）、钙通道阻滞剂（1985年）、血管紧张素转换酶抑制剂（1985年）、血管紧张素受体阻滞剂（2000年）和直接肾素抑制剂（2008年）的引入。
动脉高血压的药物治疗一直是20世纪下半叶深入且成功的研发重点。
