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高血压是心力衰竭(简称心衰)的主要归因危险,而大多数心衰患者均有高血压史。长期高血压使肾素-血管紧张素-醛固酮系统(RAAS)和交感神经系统过度兴奋;又是促进冠脉粥样硬化的主要危险因素。降压治疗可以预防和治疗心衰。降压目标水平为130/80mmHg。ACEI、ARB、β-受体阻滞剂和利尿剂均适用此类患者,通常需2～3种药物合用。其中ACEI(或ARB)加β-受体阻滞剂的合用最受推荐。钙拮抗剂(CCB)一般不用,但长作用二氢吡啶类CCB如氨氯地平或非洛地平已证实不会使心衰加重或预后恶化。收缩性心衰在利尿剂基础上应长期使用ACEI(或ARB)和β-受体阻滞剂,可降低病死率;舒张性心衰亦可应用这些药物,但只能改善症状。
Hypertension is the major risk of heart failure (HF), and most patients with HF have a history of hypertension. Long-term hypertension over-excites the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system; and is also a major risk factor for promoting coronary atherosclerosis. Antihypertensive treatment can prevent and treat heart failure. Blood pressure target level 130 / 80mmHg. ACEI, ARB, β-blockers and diuretics are suitable for such patients, usually 2 to 3 kinds of drugs combined. Which ACEI (or ARB) plus β-blockers combination of the most recommended. Calcium antagonists (CCBs) are generally not used, but long acting dihydropyridine CCBs such as amlodipine or felodipine have been shown not to exacerbate or worsen heart failure. Systolic heart failure should be based on long-term use of diuretics ACEI (or ARB) and β-blockers, can reduce the mortality; diastolic heart failure can also use these drugs, but only to improve the symptoms.