Leonetti G
Ospedale S. Luca IRCCS, Centro Auxologico Ialiano Milano, Italy.
Blood Press Suppl. 1994;4:49-52.
Arterial hypertension is a well known risk factor for atherosclerosis and its complications. Lowering of blood pressure significantly reduces the incidence of cerebrovascular events and to a minor extent that of ischemic heart disease. Interference of antihypertensive drugs on lipoproteins, glucose and electrolytes metabolism has been suggested as a hypothesis for the lower than expected protection against cardiac events. The new antihypertensive agents such as calcium antagonists, angiotensin converting enzyme inhibitors and post-synaptic alpha-1 receptor antagonists have proved to be neutral or to have positive effect on metabolic disturbances. Urapidil, a multifactorial antihypertensive agent, has been shown to significantly lower blood pressure and to have a favorable impact on the metabolic profile in adult and elderly hypertensive patients and in patients with diabetes mellitus and elevated blood pressure. Although arterial hypertension is a risk factor for atherosclerosis, the clinical events at the cerebral and coronary levels are secondary to thrombo-embolic complications. On the other hand it has been shown that abnormalities in coagulation factor has a prognostic value. Therefore, new and old antihypertensive agents should be investigated not only for their effects on hypertension, metabolic profile and quality of life but also on coagulation, in order to improve the therapeutic profile.
动脉高血压是动脉粥样硬化及其并发症的一个众所周知的危险因素。降低血压可显著降低脑血管事件的发生率，并在较小程度上降低缺血性心脏病的发生率。抗高血压药物对脂蛋白、葡萄糖和电解质代谢的干扰被认为是对心脏事件的保护作用低于预期的一个假设。新型抗高血压药物，如钙拮抗剂、血管紧张素转换酶抑制剂和突触后α-1受体拮抗剂，已被证明对代谢紊乱呈中性或具有积极作用。乌拉地尔是一种多因素抗高血压药物，已被证明能显著降低血压，并对成年和老年高血压患者以及糖尿病和高血压患者的代谢状况产生有利影响。虽然动脉高血压是动脉粥样硬化的危险因素，但脑和冠状动脉水平的临床事件继发于血栓栓塞并发症。另一方面，已经表明凝血因子异常具有预后价值。因此，应研究新旧抗高血压药物，不仅要研究它们对高血压、代谢状况和生活质量的影响，还要研究它们对凝血的影响，以改善治疗效果。
