摘要
最新荟萃分析发现,肾素-血管紧张素(Ang)-醛固酮系统(RAAS)抑制剂能降低高血压患者死亡率,其治疗获益全部源于血管紧张素转化酶(ACE)抑制剂(ACEIs),而非血管紧张素受体拮抗剂(ARBs)。RAAS可以归纳为2条轴:ACE-AngⅡ(1-8)-AT1受体轴和ACE2-Ang(1-7)-Mas受体轴,ACEIs对RAAS的2条轴均发挥良好作用,而ARBs主要作用于前者。各个指南推荐高血压相关心血管疾病治疗优先选择ACEIs,对不能够耐受者选择ARBs。我们应当重视ACEIs在高血压、冠心病、心肌梗死和心力衰竭防治中的应用,目的是降低心血管疾病患病率和死亡率的风险。
Latest meta-analysis has discovered that the renin-angiotensin-aldosterone system（RAAS） inhibitors can reduce mortality in hypertension,and the observed treatment effect resulted entirely from the class of ACE inhibitors rather than ARBs.RAAS may be summed up in two axes： ACE-AngⅡ（1-8）-AT1 receptor axis and ACE2-Ang（1-7）-Mas receptor axis.ACE inhibitors developed fine effects in both axes,whereas ARBs was major effect on the former axis.All guidelines emphasized that ACE inhibitors should be started and continued indefinitely in all patients with hypertension-related cardiovascular diseases,and ARBs were recommended in patients who were intolerant to ACE-inhibitors.We should pay attention to ACE inhibitors used in patients with hypertension,coronary heart disease,myocardial infarction and heart failure,in order to reduce the long-term risk of cardiovascular morbidity and mortality.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2012年第8期561-563,共3页
Journal of Clinical Cardiology
