Garnier L F
Service de Cardiologie, Centre Hospitalier, Vendôme.
J Mal Vasc. 1993;18(1):6-11.
Therapy of essential hypertension (HT) should not imply the simple lowering of blood pressure alone but also reduction of the trophic effects provoked on the vascular system. Regression of left ventricular hypertrophy must be combined with "remodelling" of the overall arterial network to adapt to the abnormal physical forces acting on the vascular wall. This adaptive process has both qualitative and functional effects with structural modifications of the large arterial trunks as well as the smaller arteries, provoking adverse effects once they increase vascular resistance and diminish large artery compliance. Additionally, they tend to induce chronicity of HT, particularly since at the crossroad of these pathologic processes exist anomalies of endothelial secretory function. Treatment of HT should therefore comprise care of the vascular system, inasmuch as common mechanisms of cellular hypertrophy and proliferation are found in uncomplicated hypertension and atherosclerosis.
原发性高血压（HT）的治疗不应仅仅意味着单纯降低血压，还应减少对血管系统产生的营养作用。左心室肥厚的消退必须与整个动脉网络的“重塑”相结合，以适应作用于血管壁的异常物理力。这种适应性过程具有定性和功能性影响，会导致大动脉主干以及较小动脉的结构改变，一旦增加血管阻力并降低大动脉顺应性，就会产生不良影响。此外，它们往往会导致高血压的慢性化，特别是因为在这些病理过程的交叉点存在内皮分泌功能异常。因此，鉴于在单纯性高血压和动脉粥样硬化中发现了细胞肥大和增殖的共同机制，高血压的治疗应包括对血管系统的护理。
