Wiklund I
Behavioural Medicine, Astra Hassle AB, Molndal, Sweden.
J Clin Pharm Ther. 1994 Apr;19(2):81-7. doi: 10.1111/j.1365-2710.1994.tb01116.x.
By and large, the results of the different studies on quality of life in hypertension suggest that among beta-blockers only the nonselective beta-blocker propranolol has a negative effect on well-being, being associated with depression and side-effects. The findings on diuretics are comparatively few, and mainly observed as an adverse impact on sexual function. If one broadens the treatment scenario to include mortality and morbidity, evidence of a beneficial impact has only been proven for beta-blockers and diuretics. With the primary aim of antihypertensive drug therapy given as a reduction in cardiovascular risk factors, the aim with regard to quality of life is that quality of life be maintained. The new guidelines on the management of mild hypertension issued in the United States highlight the danger of relaxing the concern for risk reduction and costs in favour of surrogate end-points, even though these may carry great significance in the individual patient.
总体而言，关于高血压患者生活质量的不同研究结果表明，在β受体阻滞剂中，只有非选择性β受体阻滞剂普萘洛尔对幸福感有负面影响，与抑郁和副作用相关。关于利尿剂的研究结果相对较少，主要表现为对性功能的不良影响。如果将治疗方案扩大到包括死亡率和发病率，仅在β受体阻滞剂和利尿剂中证明了有益影响的证据。鉴于抗高血压药物治疗的主要目标是降低心血管危险因素，那么关于生活质量的目标就是维持生活质量。美国发布的轻度高血压管理新指南强调了放松对降低风险和成本的关注而倾向于替代终点的危险，尽管这些在个体患者中可能具有重要意义。
