Bertel O, Marx B E
Cardiology Unit, Triemli Hospital, Zürich, Switzerland.
Nephron. 1987;47 Suppl 1:51-6. doi: 10.1159/000184554.
Hypertensive emergencies are defined as conditions where a seriously elevated blood pressure imposes a substantial threat to a patient's life or vital organ functions. Since acute blood pressure reduction by lowering cardiac output and/or vascular resistance itself has the potential for serious and even life-threatening complications, treatment should be given restrictively based on pathophysiological considerations concerning altered patterns of blood pressure and blood flow regulation in these patients. Ischemic treatment related complications can be avoided by a rational choice of first-line drugs. These include beta-blockers for patients with a compromised myocardial oxygen supply as in acute myocardial infarction and unstable angina as well as for patients with dissecting aneurysms and patients with pronounced catecholamine release. In other types of hypertensive emergencies, calcium antagonists have emerged as the treatment of choice with excellent efficacy and a favorable risk-benefit ratio. Sodium nitroprusside is rarely necessary in treatment failures after calcium channel blockade.
高血压急症被定义为严重升高的血压对患者生命或重要器官功能构成重大威胁的情况。由于通过降低心输出量和/或血管阻力来急性降低血压本身有可能引发严重甚至危及生命的并发症，因此应基于对这些患者血压和血流调节改变模式的病理生理考虑进行限制性治疗。通过合理选择一线药物可避免缺血性治疗相关并发症。这些药物包括用于心肌氧供受损患者的β受体阻滞剂，如急性心肌梗死和不稳定型心绞痛患者，以及夹层动脉瘤患者和儿茶酚胺释放明显的患者。在其他类型的高血压急症中，钙拮抗剂已成为首选治疗药物，疗效极佳且风险效益比良好。在钙通道阻滞剂治疗失败后，很少需要使用硝普钠。
