从老年高血压治疗的现代观点看左旋氨氯地平的临床地位张宇清.ppt

* * * * * * * * * * 小 结 CCB是我国高血压患者常用的降压药物，施慧达（苯磺酸左旋氨氯地平）的有效性、安全性，通过我国的循证医学证据已经证实。 它作为一种国产的具有自主知识产权的CCB类的降压药，已在我国的高血压治疗中发挥了巨大的作用。 * * The many pathophysiologic effects of angiotensin II, mediated by stimulation of the AT1 and AT2 receptors, have diverse consequences. It is reasonable to suggest that most of these pathophysiologic effects of angiotensin II (through the stimulation of AT1 receptors) will result in pivotal, and potentially deleterious effects throughout the cardiovascular continuum. * Epidemiologic data has established for some time that hypertensive patients are at an increased risk for developing CHD compared to their normotensive counterparts. Specifically, data from Framingham as well as others have shown that patients with BPs 140/90 mm Hg are 2-4x more likely to develop cardiovascular disease than patients with BPs 140/90 mm Hg. Additionally, data has shown that reductions in BP through intervention can significantly decrease the risk of a cardiovascular event in the hypertensive patient. * * NVP0000901 CADUET? Global Speaker Slide Kit Version 2 There is a clear association between BP reduction and the risk of CV events. The CV protective effect of antihypertensive therapy was demonstrated by the findings of a meta-analysis of 29 trials in over 160,000 patients that compared different treatments or a treatment vs. placebo. The findings showed a clear association between a reduction in BP and in the relative risk of stroke, major CV disease, coronary heart disease, CV disease death and total mortality; the larger reductions in BP produced larger reductions in risk. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 2003;362:1527-35. * * * ADVANCE Investigator mtg ESC * * * ACTION试验结果表明在二级有效性终点方面与安慰剂比较，硝苯地平组在减少冠状动脉造影（-18%, P=0.0001）、CABG(-21%, P=0.0021) 的需要。 * * The resu