Kjeldsen S E, Syvertsen J O, Lund-Johansen P
Hjertemedisinsk avdeling, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1996 Jan 10;116(1):61-3.
Antihypertensive treatment with diuretics and/or beta-blockers lowers stroke and coronary heart disease morbidity and mortality. However, although the newer antihypertensives induce effective control of blood pressure and regression of hypertensive organ damage, it has not been proven whether they reduce mortality. Ongoing clinical trials such as STOP II, CAPPP, NORDIL, INSIGHT, ALLHAT and LIFE test whether antihypertensive regimens with ACE-inhibitor, calcium-blocker, alpha-blocker and Angiotensin II-antagonist are equally good or possibly even better than diuretics and beta-blockers in preventing cardiovascular complications. The HOT trial clarifies how much the diastolic blood pressure should be lowered, and whether a small dose of aspirin has a protective effect when combined with optimal control of blood pressure. These studies should give better guidelines for the treatment of hypertension.
使用利尿剂和/或β受体阻滞剂进行抗高血压治疗可降低中风和冠心病的发病率及死亡率。然而,尽管新型抗高血压药物能有效控制血压并使高血压性器官损害消退,但尚未证实它们能否降低死亡率。正在进行的临床试验,如STOP II、CAPPP、NORDIL、INSIGHT、ALLHAT和LIFE,正在测试使用ACE抑制剂、钙通道阻滞剂、α受体阻滞剂和血管紧张素II拮抗剂的抗高血压方案在预防心血管并发症方面是否与利尿剂和β受体阻滞剂同样有效,甚至可能更好。HOT试验阐明了舒张压应降低多少,以及小剂量阿司匹林与最佳血压控制联合使用时是否具有保护作用。这些研究应为高血压治疗提供更好的指导方针。