Gavras H, Gavras I
Department of Medicine, Boston University Medical Center, Massachusetts, USA.
Cardiol Clin. 1995 Nov;13(4):593-8.
From the five broad classes of antihypertensive drugs that have been in use long enough for adequate clinical experience to be obtained, the most recent report of the Joint National Committee on Hypertension recommends drugs from two older classes--the diuretics and the beta-adrenergic blockers--as first-line treatment. This article argues that newer drugs and in particular the angiotensin-converting enzyme inhibitors may be equally or more appropriate as first choice. Physicians should choose on the basis of a drug's pharmacologic properties and the patient's clinical profile, rather than according to a generic set of rules. Considering that the goals of modern antihypertensive therapy are not only lowering of blood pressure to prevent complications, but also long-term cardioprotection without adverse effects on the quality of life, some newer drugs might even prove more cost-effective in the long run.
在已使用足够长时间以积累充分临床经验的五大类抗高血压药物中，美国国家高血压联合委员会的最新报告推荐两类较老的药物——利尿剂和β-肾上腺素能阻滞剂——作为一线治疗药物。本文认为，更新的药物，尤其是血管紧张素转换酶抑制剂，可能同样适合或更适合作为首选。医生应根据药物的药理特性和患者的临床情况进行选择，而不是按照一套通用规则。鉴于现代抗高血压治疗的目标不仅是降低血压以预防并发症，还包括长期心脏保护且不对生活质量产生不良影响，从长远来看，一些更新的药物甚至可能被证明更具成本效益。
