Wilson T W, Quest D W
Department of Pharmacology, University of Saskatchewan, Saskatoon.
Can J Public Health. 1994 Sep-Oct;85 Suppl 2:S48-50.
The past two decades have witnessed major improvements in antihypertensive drug therapy. Although diuretics and beta-adrenergic antagonists remain the drugs of choice, we now recommend much lower doses than we previously did. This appears to achieve equal blood pressure control while causing fewer side effects. Angiotensin-converting enzyme inhibitors and calcium antagonists are newer, relatively expensive drug classes whose benefits can be exploited in certain subgroups of patients. Whether they will lead to improved outcome in the uncomplicated hypertensive patient remains uncertain. New classes of drugs affecting the renin-angiotensin system are in various stages of development. Again, they have theoretical advantages over those currently available. Still other classes--thromboxane synthase or receptor antagonists and endothelin antagonists--appear promising in animal studies. Finally, in future, it may be possible to cure hypertension by altering a patient's genetic make-up.
在过去二十年中，抗高血压药物治疗取得了重大进展。虽然利尿剂和β-肾上腺素能拮抗剂仍然是首选药物，但我们现在推荐的剂量比以前低得多。这似乎能在控制血压的同时减少副作用。血管紧张素转换酶抑制剂和钙拮抗剂是较新的、相对昂贵的药物类别，其益处可在某些亚组患者中得到利用。它们是否能改善单纯高血压患者的预后仍不确定。影响肾素-血管紧张素系统的新型药物正处于不同的研发阶段。同样，它们在理论上比现有药物更具优势。还有其他一些药物类别——血栓素合成酶或受体拮抗剂以及内皮素拮抗剂——在动物研究中似乎很有前景。最后，未来有可能通过改变患者的基因组成来治愈高血压。
