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心血管疾病的预防取得长足的进步,但是在发达国家中风和心梗仍然是主要死亡原因。高血压的治疗,在预防冠心病方面效果欠佳。Framingharn研究表明,根据危险因子和临床前终末器官病变可以将相等收缩压的患者进行危险度分层。14项临床试验经荟萃分析表明,舒张压增加1kPa,中风增加40％,心脏病发作增加28％。事实上,舒张压降低0.67～0.8kPa,中风减少40％,心脏病发作只减少14％(即只及预期减少百分率的一半)。利尿剂影响脂质和葡萄糖代谢并影响电解质水平,β阻滞剂影响脂质和葡萄糖代谢,从而抵消降压的好处。降压幅度
Great progress has been made in the prevention of cardiovascular disease, but stroke and MI are still the major causes of death in developed countries. Hypertension treatment, in the prevention of coronary heart disease ineffective. Framingharn studies have shown that patients with equal systolic blood pressure can be stratified according to risk factors and pre-clinical end organ disease. Meta-analysis of 14 clinical trials showed that diastolic blood pressure increased by 1 kPa, stroke increased by 40% and heart attack increased by 28%. In fact, diastolic blood pressure decreased by 0.67-0.8 kPa, stroke decreased by 40%, and heart attack decreased by only 14% (ie, only half of the expected reduction). Diuretics affect lipid and glucose metabolism and affect electrolyte levels, and beta blockers affect lipid and glucose metabolism, offsetting the benefits of blood pressure. Buck rate