Burris J F
Georgetown University Medical Center, Washington, DC 20007, USA.
J Natl Med Assoc. 1995 May;87(5):359-62.
Hypertension is highly prevalent among African Americans, who are also more likely than whites to develop end-organ complications of hypertension. Traditional diuretic-based stepcare therapy has successfully reduced such complications of hypertension as stroke, congestive heart failure, and premature death in all populations tested. Prevention of coronary deaths has been less successful. Potentially adverse metabolic effects of thiazide diuretics and some beta-blockers may partially explain the less successful cardiac outcomes. Use of antihypertensive agents lacking adverse metabolic effects but still achieving effective blood pressure control could improve cardiac outcomes while maintaining the benefits achieved with older forms of therapy. Achievement of improved cardiac outcomes is now one of the principal goals of hypertension research and treatment.
高血压在非裔美国人中极为普遍，他们比白人更易出现高血压的终末器官并发症。传统的基于利尿剂的阶梯式护理疗法已成功降低了在所有受试人群中高血压的此类并发症，如中风、充血性心力衰竭和过早死亡。预防冠心病死亡的成效则较差。噻嗪类利尿剂和某些β受体阻滞剂潜在的不良代谢效应可能部分解释了心脏方面成效较差的原因。使用缺乏不良代谢效应但仍能有效控制血压的抗高血压药物，可能会改善心脏方面的成效，同时维持以往治疗方式所取得的益处。实现更好的心脏方面成效如今是高血压研究和治疗的主要目标之一。
