Gullickson C
University of Wisconsin-Madison, School of Nursing.
Nurse Pract. 1993 Feb;18(2):30-2, 37, 41.
Despite adequate pharmacological alternatives, only a minority of individuals living with hypertension achieve normotensive blood-pressure levels. Numerous medical and behavioral strategies have been implemented in an attempt to increase adherence to therapeutic regimens. Most of these techniques have resulted in short-term adherence improvement and a high degree of relapse in the period following experimentation, making assessment of potential long-term benefits of therapy impossible. Regardless of the strategy selected, active patient participation has been consistently identified as a critical element in improving adherence. This article describes a new pharmacological management strategy for individuals with mild hypertension. This strategy allows individuals to sample different antihypertensive medications for a period of four weeks to six weeks and select their preferred drug of choice for hypertension management based on the individuals' subjective responses to therapy. When used with different beta blockers, this management approach has provided effective control of mild hypertension and has kept clients in therapy when other strategies have failed.
尽管有足够的药物替代方案，但只有少数高血压患者能达到正常血压水平。为了提高对治疗方案的依从性，人们实施了许多医学和行为策略。这些技术大多只能在短期内提高依从性，且在试验后的一段时间内复发率很高，因此无法评估治疗的潜在长期益处。无论选择何种策略，患者的积极参与一直被视为提高依从性的关键因素。本文介绍了一种针对轻度高血压患者的新药理管理策略。该策略允许患者在四到六周的时间内试用不同的抗高血压药物，并根据个体对治疗的主观反应选择他们首选的高血压治疗药物。当与不同的β受体阻滞剂联合使用时，这种管理方法有效地控制了轻度高血压，并且在其他策略失败时能使患者坚持治疗。
