21.治疗高血压的药物Antihypertensive drugs——山东大学药理学英文课件.pptVIP

 Antihypertensive drugs Lou haiyan louhaiyan@sdu.edu.cn Section 1 Introduction Definition Hypertension is defined as a sustained diastolic blood pressure (DBP) greater than 90mmHg or systolic blood pressure (SBP) greater than 140mmHg. The Types of Hypertension Essential hypertension 90% Secondary hypertension 10% Primary (essential) hypertension Nearly 90% of patients have no specific cause. Elevated blood pressure is usually caused by several abnormalities such as genetic inheritance, psychological stress, dietary factors. Treatment: Such hypertension can be controlled by some combination of antihypertensive drugs and changes in daily habits. Secondary hypertension 10% -15% of patients has a specific cause, such as renal artery constriction, primary aldosteronism or tumors of the adrenal glands (pheochronocytoma). Treatment: Pathophysiology of hypertension Genetic factor Activation of sympathetic nervous system Activation of RAAS （renin-angiotensin-aldosterone system） Na+ Dysfunction of vascular endothelium Normal regulation of blood pressure Response mediated by the sympathetic nervous system 全国高血压日历年主题 10月8日 1998年：“了解您的血压”。 1999年：“控制高血压，保护心脑肾”。 2000年：“普及高血压知识，减少高血压危害”。 2001年：“控制高血压，享受健康生活”。 2002年：“战胜高血压从社区做起！” 2003年：“保持健康生活方式，控制高血压” 2004年：“高血压与代谢综合征”。 2005年: “血压与卒中”。 2006年: “降压达标” Treatment of hypertension Diet Loss weight Exercise Antihypertensive drugs 高血压的治疗目标 确切降压 稳定降压 阻断RAS,减轻或逆转靶器官损伤，降低并发症的发生率和病死率。 抗高血压治疗的目标血压： 一般 140/90mmHg 糖尿病、肾病患者 130/80mmHg The classification of antihypertensive agents 1. Diuretics 2. Calcium channel blocks 3. RAS inhibitors: ACEI( angiotensin converting enzyme inhibitors) AT1 receptor antagonist (angiotensin Ⅱ typeⅠ receptor antagonist ) Renin inhibitors 4. Sympathoplegic agents: Centrally acting agents Ganglion-blocking agents Adrenergic neuron-blocking agents Adrenoceptor antagonist β-adrenergic antagonist α1-adrenergic antagonist Mixed adrenergic ant