Moser M
Department of Internal Medicine, Yale University School of Medicine.
Cleve Clin J Med. 1993 Jan-Feb;60(1):27-37. doi: 10.3949/ccjm.60.1.27.
In medicine, as in other fields, myths or speculations may be repeated so often and so widely that they are perceived as fact. To some extent, this may have occurred with regard to the treatment of hypertension, especially concerning the use of diuretics and beta blockers and the significance of their metabolic effects. An analysis of the available data indicates that the use of diuretics and, to some extent, beta-adrenergic inhibitors will effectively lower blood pressure and reduce morbidity and mortality. Similar analyses strongly suggest that the metabolic changes induced by these agents may not be of major clinical importance. The widespread dissemination of theories and speculations designed to convince physicians to avoid their use may have been overdone. Scientific facts, not extrapolations of data, should be used to make treatment decisions.
在医学领域，如同在其他领域一样，一些神话或推测可能会被反复且广泛地传播，以至于被人们当作事实。在某种程度上，高血压治疗方面可能就出现了这种情况，尤其是在利尿剂和β受体阻滞剂的使用以及它们代谢效应的重要性方面。对现有数据的分析表明，使用利尿剂以及在一定程度上使用β肾上腺素能抑制剂能有效降低血压，并减少发病率和死亡率。类似的分析有力地表明，这些药物引起的代谢变化可能不具有重大临床意义。那些旨在说服医生避免使用这些药物的理论和推测的广泛传播可能有些过头了。应该依据科学事实，而非数据推断来做出治疗决策。
