Purcell H, Coats A
Royal Brompton Hospital, London, UK.
Br J Clin Pract. 1994 Nov-Dec;48(6):311-6.
Hypertension is accompanied by a series of structural adaptations and pathological alterations in the heart and vessels. These include hypertrophy of the left ventricle and walls of resistance vessels, degeneration of elastic components in the walls of large arteries, atherosclerosis and glomerulosclerosis. In order to improve prognosis it is important that the antihypertensive drugs used can prevent or regress these processes, and this review focuses on the experience with the vascular selective calcium antagonist felodipine. Clinical studies show that antihypertensive treatment with felodipine promotes regression of left ventricular hypertrophy, increases compliance of large arteries, and has favourable effects on renal function. In addition, experimental data have shown that felodipine inhibits atherosclerotic plaque development. As structural cardiovascular changes appear early in hypertension, intervention with antihypertensive therapy is better initiated sooner than later. Vascular selective calcium antagonists, such as felodipine, appear effective in reducing blood pressure and in ameliorating hypertension-induced structural changes.
高血压伴随着心脏和血管的一系列结构适应性变化和病理改变。这些变化包括左心室肥厚和阻力血管壁增厚、大动脉壁弹性成分退变、动脉粥样硬化和肾小球硬化。为改善预后，所用的抗高血压药物能够预防或逆转这些过程非常重要，本综述聚焦于血管选择性钙拮抗剂非洛地平的应用经验。临床研究表明，非洛地平抗高血压治疗可促进左心室肥厚消退，增加大动脉顺应性，并对肾功能产生有利影响。此外，实验数据表明非洛地平可抑制动脉粥样硬化斑块形成。由于心血管结构变化在高血压早期就已出现，抗高血压治疗干预宜早不宜迟。血管选择性钙拮抗剂，如非洛地平，似乎在降低血压和改善高血压引起的结构变化方面有效。
