Leonetti G, Cuspidi C
Ospedale S. Luca, Istituto Ricovero e Cura a Carattere Scientifico, Centro Auxologico Italiano, Milan, Italy.
J Hypertens Suppl. 1995 Aug;13(2):S29-34. doi: 10.1097/00004872-199508001-00005.
To review present knowledge on the causes of cardiovascular changes in hypertension and on the effects of antihypertensive treatment.
The clinical manifestations of hypertensive heart disease have changed considerably in recent decades, from predominantly cardiac failure to predominantly left ventricular hypertrophy, which is an independent risk factor for all cardiovascular events. This change parallels the recent development of ultrasonic devices which make it possible to investigate the vessels as well as the heart. These devices have shown that there are different types of cardiac remodeling, which are associated with different hemodynamic profiles.
Recent studies have shown that antihypertensive treatment, both pharmacological and non-pharmacological, can significantly reduce left ventricular hypertrophy in hypertensive patients without jeopardizing the hemodynamic balance. However, hypertensive vessel disease has been less extensively investigated, with many studies concentrating on the carotid arteries. There appears to be a correlation between cardiac and carotid artery changes but so far there is no information on the effects of the antihypertensive treatment on the carotid alterations.
综述目前关于高血压心血管变化原因及降压治疗效果的知识。
近几十年来，高血压性心脏病的临床表现发生了显著变化，从以心力衰竭为主转变为以左心室肥厚为主，左心室肥厚是所有心血管事件的独立危险因素。这种变化与超声设备的最新发展同步，超声设备使研究血管和心脏成为可能。这些设备显示存在不同类型的心脏重塑，且与不同的血流动力学特征相关。
最近的研究表明，无论是药物治疗还是非药物治疗，降压治疗都能在不危及血流动力学平衡的情况下显著减轻高血压患者的左心室肥厚。然而，高血压血管疾病的研究较少，许多研究集中在颈动脉。心脏和颈动脉变化之间似乎存在相关性，但目前尚无关于降压治疗对颈动脉改变影响的信息。
