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过去的20年,流行病学的研究已鉴定出心血管疾病的诸危险因素,如高血压、高脂血症、糖尿病、吸烟以及增加饱和脂肪的摄入等。两种或两种以上的危险因素同时存在对病人的心血管疾病危险具有协同作用,而不是单纯的相加效果。实验证明,降低高血压病人的血压可持续地、显著地、即刻地减少卒中发生率。这是一个令人振奋的发现,且有力地说明了即使轻度高血压也有治疗的必要。然而,使人失望的是,许多抗高血压药物的研究并不证明可降低冠心病的死亡率。抗高血压治疗的意外失败,迫使对高血压的研究重新进行仔细的和全面的评价。
In the past two decades, epidemiological studies have identified risk factors for cardiovascular disease such as hypertension, hyperlipidemia, diabetes, smoking, and increased saturated fat intake. The simultaneous presence of two or more risk factors has a synergistic effect on the patient’s risk of cardiovascular disease, rather than a mere additive effect. Experiments have shown that reducing blood pressure in hypertensive patients reduces the incidence of stroke sustainably, significantly and instantly. This is an exciting finding and provides a powerful explanation for the need for treatment even with mild hypertension. However, what is disappointing is that many antihypertensive studies have not demonstrated a reduction in coronary heart disease mortality. The unexpected failure of antihypertensive treatment has forced the study of hypertension to undergo a careful and comprehensive review.