论文部分内容阅读
高血压治疗的后果颇为复杂。美国退伍军人管理局协作研究组的各类高血压患者接受降压治疗后,多种并发症例如充血性心力衰竭、肾功能不全、恶性高血压、特别是脑卒中均显著减少。但是在5项研究中,积极治疗组心肌梗塞的发生率比安慰剂组平均降低仅7％(324/11284对348/11237)。对此令人沮丧的结果,作者认为原因如下。安慰剂组并发症发生率过低 (1)诊断标准不严:例如在澳大利亚治疗试验和标准安慰剂对照试验中服用安慰剂的最初几周内30～40％高血压患者血压恢复正常,这些患者的大多数很可能不是真性高血压。(2)生活方式改变:参加试验后患者更注意
The consequences of high blood pressure treatment are quite complicated. A variety of complications such as congestive heart failure, renal insufficiency, and malignant hypertension, particularly stroke, have been significantly reduced in all types of hypertensive patients in the WVA collaborative study group after antihypertensive treatment. However, in five studies, the incidence of myocardial infarction in the active treatment group was reduced by an average of 7% (324/1 1284 vs 348/11237) over the placebo group. The frustrating result of this, the author thinks the reason is as follows. Low complication rates in placebo group (1) Poor diagnostic criteria: for example, blood pressure was normalized in 30-40% of hypertensive patients during the first few weeks of placebo in the Australian treatment trial and the standard placebo-controlled trial, and these patients Most likely are not true hypertension. (2) changes in lifestyle: more attention to patients after participating in the trial