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高血压能引起心血管并发症,血压下降至少能部分地减少这种危险。这种认识极大地刺激了开发大批能使高血压患者降低血压的新药。利尿剂、β-肾上腺素受体阻滞剂、钙通道拮抗剂和血管紧张素转化酶(ACE)抑制剂等四类抗高血药已成为临床一线的首选药物。由于它们的药理学性质和抗高血压机制不同,它们之间可互相补充。事实上由于存在患者的个体差异性,单药治疗常常不能奏效。因此熟悉每类药物的药效学性质、采用联合疗法来获得增效效果和减轻单药治疗引起的不良反应是极为重要的。本文目的是简述四大类抗高血压药物不同的心血管作用,并证明某些抗高血压治疗的序贯用药或联合用药是合理的。
Hypertension can cause cardiovascular complications, and blood pressure drops can at least partially reduce this risk. This understanding has greatly stimulated the development of a large number of new drugs that can lower blood pressure in hypertensive patients. Four types of antihypertensive drugs such as diuretics, β-adrenoceptor blockers, calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors have become the first-line drugs of choice. Due to their different pharmacological properties and anti-hypertensive mechanisms, they complement each other. In fact, monotherapy often fails to work because of the individual differences in patients. It is therefore important to be familiar with the pharmacodynamic properties of each type of drug, to use synergistic therapies to achieve synergistic effects and to reduce the adverse effects of monotherapy. The purpose of this article is to outline the different cardiovascular effects of the four broad categories of antihypertensives and to justify the sequential or combined use of certain antihypertensive treatments.