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在大多数慢性原发性高血压患者,周围血管阻力异常增高是动脉血压升高的主要原因。他们的心排出量一般在正常范围,虽则在疾病早期可以升高;当并发心力衰竭时可低于正常。高血压患者的动脉压可通过减少心排出量或降低总周围阻力而降低,但是前一种途径却又增加了另一种血液动力学异常。在通过减少心排出量而使动脉压正常的慢性高血压患者,其循环呈双重异常:血管阻力仍然过高而心排出量则变为异常低下。这种情况不可避免地会导致组织灌注降低,包括心、脑、肾,因此不是理想的目标。比较可取
In most patients with chronic essential hypertension, abnormal peripheral vascular resistance is the main cause of arterial blood pressure. Their cardiac output is generally in the normal range, although it may increase early in the disease; when heart failure may be lower than normal. Arterial pressure in hypertensive patients can be reduced by decreasing cardiac output or decreasing total peripheral resistance, but the former increases another hemodynamic abnormality. In chronic hypertensive patients with normal arterial pressure by reducing cardiac output, the circulation is a double abnormality: vascular resistance is still too high and cardiac output becomes abnormally low. This situation will inevitably lead to reduced perfusion of tissue, including heart, brain, kidney, and therefore not the ideal goal. More desirable