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β 受体阻滞剂在高血压应用中的专家指导 建议
β 受体阻滞剂在高血压应用中的专家指导 建议
20 5 [4] 30%[5]
60 2007 2009
13 078 60%
61.9%[6]
2006 2007 EU-ROASPIRE
[1]
Lindholm 87.5%
2006 NICE [7]
[2]
1.3
1 2005 Lindholm Lindholm
1.12010
4 [ [1] NICE
CCB Lindholm
ACEIARB ]
5 1
24 [8]
[3]
1.2
[9]
Email nlsun@263.net
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2013 5 4 59
2.2.2
2 MAPHY[17]MRC-2[18]IPPPSH[19]STOP-
2.1 Hypertension[20] CONVINCE[21]
- RAS 147
CCBACEIARB
[22]
LIFE [23] ASCOT-BPLA
[24]
2.2
2.2.1 1292 LIFE ASCOT-
BPLA
[10] [11]
GENRES 208 Lindholm
5 mg [1]
5 mg 25 mg 50 mg 4
24 11/8 mm Hg1 16% 95%CI 4% 30%
mm Hg 0.133 kPa
7/5 mm Hg5/2 mm Hg
[12]
9/6 mm HgBRIGT 2161
12 PWV
25.29 mm Hg 14.14
mm Hg 96.44% [25] 2
2.2.3
1
1 2
1
W mg mm Hg mm Hg /
5 102 / vs. 149.7/97.6 135.4/85.6 11.7
277 4
[13] 25 502 / 150.5/98.1 138.0/88.8 10.7
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60 2013 5 4
2
MRC-1 4369 5.8 Atenololdiuretic vs. PL 25% 19% 17%
MAPHY 3234 5.0 Metoprolol vs. HCTZ P 0.028
P 0.048P 0.017
IPPPSH 6357 4.0 Oxprenolol vs. PL 17%
CONVINCE 16 476 3.0 Atenolol vs. verapamil HR 1.02 P 0.77
UKPDS[26] 758 9.0 Atenolol vs.captopril HR 1.14 P 0.44
NORDIL [27]
10881 4.5 Any -blocker vs.diltiazem
P 0.04
ELSA[28] 2334 3.8 Atenolol vs.lacidipine
INVEST[29] 22576 2.7 Atenolol vs. verapamil 10.17%
vs.9.93%
LIFE 9193 4.8 Atenolol vs. Losartan 13% 25%
ASCOT-BPLA 19 257 5.7 Atenolol vs. Amlodipine 23% P 0.0003
25%P 0.0001
Atenolol diuretic PL Metoprolol HCTZ Oxprenolol
verapamil Losartan Amlodipine ;lacidipine: captopril
[30]
,
24
1 NO
24 [35, 36]
[31]
3 2011
80 mg/d [37]
[32]
100 mg/d 3
5 mg/d 50 100 mg/d 3.1
1 [38]
3.1.1 1 2
[33]
P 0.01
4 2
145 811
RR 0.9795% CI 0.88 1.07 3.1.2 1 1
RR 1.0695% 2
[34]
CI 1.01 1.10
3.1.3
5 1
3
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2013 5 4
61
NO 3.2.2
3.2 [38]
3.2.3
3.2.1
1
3
1 1
% %
6 10 0 10 50 60 + -
10 12 10 90 + -
50 60 40 50 + -
34
12 24
67 60 75 30 - +
10 12 0 85 - +
12 19 70 12 96 + -
3 1 2
3.3 [43]
3.3.1 3.3.4
1 1
78% 1 24 2
2
3.3.5
1
[39]
3 NO
3.3.2 2
ISA
70% CYP2D6 CYP2D6
1 [44]
4
[40,41]
CYP2D6* 10 4.1 5
[42]
1 2
24 1 CCB CCB
3.3.3
1
2010
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62
2013 5 4
4065
61 70 / 80 4.2
/ 39%
4.2.1
[45]
70 / LIFE
84 / 84 / REACH
1.59
[46]VALUE 1 [50]
80 / [51]
53% BP 140/90 mm Hg
[47]
34% 2011
[37]
70 /
1
4.8
J 60 75 / 2012 ST
[48]
1
A[52]2010 ST
24
1B[53]2012
[49] AHA
1A
1B
ACEI ARB ACEI [54] INVEST
22 576
75 / 5
/ 6%[29]
140/90 mm Hg
60 75 / 55 60 /
20 /
50 / [55]
ACEI ARB
4.2.2
HFPEF
75 / 75 / 70% HFPEF
CCB
ACEI ARB
1
ACEI ARB
CCB ARBACEI
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2013 5 4 63
3
[60]
CIBIS MERIT-HF[61] COPERNICUS[62] 50 60 / 55 60 /
1
130 80 mm Hg
34% 35% 41% 44%
ACEI ARB
MDC [63] ACEI ARB
5
2007 5.1
[64]
SENIORS 75 /
[65]
5.2
NYHA
NYHA B
[ LVEF 40%] 5.3
[66]
75 /
1.25
mg 1 12.5 mg 1
6.25 mg 2 3 60 75 /
3.125 mg 2 2 4 5.4
55 /
CCB
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64
2013 5 4
323264-269
5.7 [5] Wolf M, Heuten HG, De Swaef A , et al. The evolution of
hypertension treatment in Belgium, a pharmacoepidemiological
study[J]. Acta Cardiol, 2012, 67(2):147-152.
[6]
6 [J]2011
276422-425
[7] Pajak A, Jankowski P, Kawecka-Jaszcz K, et al. Changes in
secondary prevention of coronary artery disease in the post-
discharge period over the decade 1997-2007. Results of the
Cracovian Program for Secondary Prevention of Ischaemic
Heart Disease and Polish parts of the EUROASPIRE and
surveys[J]. Cardiol Pol, 2009 , 67(12):1353-1359.
[8] Neutel JM, Schnaper HCheung DGet al. Antihypertensive
effects of beta-blockers administered once daily: 24-hour
measurements[J]. Am Heart J, 1990, 120(1):166-171.
1 [9]
[J]201127
6422-425
[10] Materson BJ, Reda DJ, Cushman WC. Am J Hypertens.
Department of veterans Affairs single-drug therapy of
CCB
hypertension study. Revised gures and new data. Department of
ACEI ARB Veterans Affairs Cooperative Study Group on Antihypertensive
Agents[J]. Am J Hypertens, 1995, 8(2):189-192.
[11] Suonsyrj T, Hannila-Handelberg T, Paavonen KJ, et al.
Laboratory tests as predictors of the antihypertensive effects
of amlodipine, bisoprolol, hydrochlorothiazide and losartan
in men: results from the randomized, double-blind, crossover
GENRES Study[J]. J Hypertens, 2008, 26(6):1250-1256.
[12] Channaraya V, Marya RK, Somasundaram M, et al. Efficacy
and tolerability of a -1 selective blocker, bisoprolol, as a
first-line antihypertensive in Indian patients diagnosed with
essential hypertension (BRIGHT): an open-label, multicentric
observational study[J]. BMJ Open, 2012, 2(3): e000683
[13]
[J] 2011192163-
166
[14]
[J]
2006144314-316
[15]
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