摘要
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。
Patients with hypertension are at risk of chronic heart failure（CHF） and management of bypertension will reduces the risk of CHF. ACE inhibitor, angiotension Ⅱ receotor antagonists （ARB）, Beta-Blockers and diuretics are appear to be more effective than calcium channel blockers in preventing or dslaying the onset of CHF. The target BP that should be reached in patients with CHF is 130/80 mmHg. There is strong evidence from clinical trials show that the combination of two or three antihypertensive drugs above is reasonable. The use of ACE inhibitors/ARB and beta-biockers in all patients with established systolic heart failure who do not have contraindications is the preferred choice with the reduce of mortality. No treatment has yet been shown, convincingly, to reduce morbidity and mortality in patients with diastolic heart failure.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2010年第3期198-199,共2页
Chinese Journal of Practical Internal Medicine
关键词
心力衰竭
高血压
heart failure
hypentension
