Barrie W
Department of Veterans Affairs Medical Center, University of Michigan School Medicine, Ann Arbor, 48105, USA.
West J Med. 1996 Apr;164(4):303-9.
The costs of treating hypertension are out of control. The Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure and others recommend the use of diuretics and beta-blockers as first-line agents. Newer drugs such as calcium channel blockers, alpha-blockers, and angiotensin-converting-enzyme inhibitors have improved metabolic profiles, but have not been proved in long-term, randomized, controlled trials to reduce morbidity and mortality. Our General Medicine Clinic has gradually shifted toward prescribing the newer agents. We reviewed our drug use, evaluated the literature, and made recommendations in the form of guidelines. Clinicians' concerns included quality-of-life issues, sexual dysfunction, metabolic changes--lipids, potassium, insulin resistance--and others. These concerns were addressed, and a consensus was reached. Our goal is to streamline therapy, reduce costs, and provide proven effective medication.
高血压的治疗费用已失去控制。全国高血压检测、评估与治疗联合委员会及其他机构建议将利尿剂和β受体阻滞剂作为一线用药。新型药物如钙通道阻滞剂、α受体阻滞剂和血管紧张素转换酶抑制剂具有改善的代谢特征，但尚未在长期随机对照试验中被证明能降低发病率和死亡率。我们的普通内科门诊已逐渐转向开具新型药物。我们回顾了用药情况，评估了文献，并以指南的形式提出了建议。临床医生关注的问题包括生活质量问题、性功能障碍、代谢变化（血脂、钾、胰岛素抵抗等）以及其他问题。这些问题都得到了解决，并达成了共识。我们的目标是简化治疗、降低成本，并提供经证实有效的药物。
