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当今抗高血压疗法的若干问题抗高血压疗法已证明能减少卒中和心力衰竭发病率,但不能明显预防冠脉粥样硬化并发症,如心脏猝死或心肌梗塞。这是因为,利尿剂和β阻滞剂对血脂代谢、血糖代谢、胰岛素抗性和生活质量等产生不良影响。当高血压伴有心脏病时,强效利尿剂引起的低血钾可诱发致死性心律失常,这一危害近年始被认识。利尿剂增加血浆总胆固醇、LDL-胆固醇和甘油三酯;β阻滞剂则增加甘油三酯,降低HDL胆固醇。当两者并用时更甚。现已证实,总胆固醇或LDL-胆固醇每增加1％,冠脉疾病
Some Problems with Antihypertensive Therapy Today Antihypertensive therapy has been shown to reduce the incidence of stroke and heart failure but does not significantly prevent coronary atherosclerotic complications such as sudden cardiac death or myocardial infarction. This is because diuretics and beta blockers have an adverse effect on blood lipid metabolism, blood glucose metabolism, insulin resistance and quality of life. When high blood pressure associated with heart disease, potent diuretic-induced hypokalemia can induce lethal arrhythmia, the harm has been recognized in recent years. Diuretics increase plasma total cholesterol, LDL-cholesterol and triglycerides; beta-blockers increase triglycerides and lower HDL cholesterol. When the two are used even more. It has been confirmed that for every 1% increase in total cholesterol or LDL-cholesterol, coronary artery disease