高血压和小血管疾病:这些药物有效吗?
Philip S Nash1,2, Rob J Simister1,2, David C Wheeler3
1Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, University College London, London, UK.
British journal of hospital medicine (London, England : 2005)
|September 28, 2023
概括
治疗高血压可以预防小血管疾病和慢性病的进展. 支持低于130/80mmHg的血压目标,但需要更多关于预防痴呆症密集目标的研究.
科学领域:
- 神经学 神经学
- 腎臟病學 (nephrology) 是一種醫學.
- 心血管医学 心血管医学
背景情况:
- 高血压与缺血性中风,脑内出血和慢性病密切相关.
- 大脑小血管疾病与脏疾病具有病理生理相似之处,这表明有共同的潜在机制.
- 目前,关于高血压治疗是否可以预防小血管疾病进展的证据有限.
研究的目的:
- 批判性地评估高血压管理的证据,以预防小血管疾病的进展.
- 在高血压的背景下审查预防慢性病进展的数据.
- 为了确定脑血管和脏健康的最佳血压目标.
主要方法:
- 对现有的科学文献和临床研究进行批判性评估.
- 综合证据关于高血压对小血管疾病和慢性病的影响.
- 分析支持特定血压治疗目标的数据.
主要成果:
- 有证据支持血压目标为<130/80 mmHg,以优化预防小血管疾病和慢性病进展.
- 大脑和脏血管之间共享的病理生理过程被假设是由于高血压对两个器官的影响.
结论:
- 建议血压目标<130/80 mmHg,以减缓小血管疾病和慢性脏疾病的进展.
- 需要进一步的研究,以了解密集血压管理对小血管疾病和痴呆症发病率的长期影响.
相关概念视频
Antihypertensive Drugs: Vasodilators
556
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
556
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
454
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
454
Hypertension IV: Drug Therapy and Lifestyle Modifications
12
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
12
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
683
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
683
Antihypertensive Drugs: Angiotensin II Receptor Blockers
771
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
771
Antihypertensive Drugs: Action of Diuretics
804
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
804


