Mancia G, Lanfranchi A, Cattaneo B M, Grassi G
Division of Internal Medicine, San Gerardo Hospital, Monza, University of Milan, Italy.
Cardiology. 1994;85 Suppl 1:58-64. doi: 10.1159/000176761.
Hypertension is usually symptomless and associated with little or no alterations in well-being. However, conclusive evidence demonstrates that hypertension is a major risk factor for cardiovascular disease. A reduction of the elevated blood pressure with antihypertensive medication can reduce this risk, but not to that of a normotensive patient. Furthermore, antihypertensive treatment is more effective against stroke and congestive heart failure than against coronary heart disease. Antihypertensive treatment is costly due to its extensive use and life-long indication. Future progress in this area will aim to identify those hypertensive patients at greatest risk of cardiovascular disease, in order to limit treatment to those patients who may benefit most. This paper will consider the effects of blood pressure reduction on cardiovascular morbidity and mortality, the differing effects of antihypertensive treatment on the complications of hypertension, and how antihypertensive therapy can be optimized.
高血压通常没有症状，与健康状况几乎没有或没有改变相关。然而，确凿证据表明高血压是心血管疾病的主要危险因素。使用抗高血压药物降低升高的血压可以降低这种风险，但不能降至血压正常患者的水平。此外，抗高血压治疗对中风和充血性心力衰竭的效果比对冠心病的效果更好。由于其广泛使用和终身适应症，抗高血压治疗成本高昂。该领域未来的进展将旨在识别心血管疾病风险最高的高血压患者，以便将治疗限制在可能受益最大的患者身上。本文将考虑血压降低对心血管发病率和死亡率的影响、抗高血压治疗对高血压并发症的不同影响，以及如何优化抗高血压治疗。
