高血压的现代治疗从1951年起的两种药物,即肼酞嗪与六烃季胺,发展到目前40多种药物,这些药物可分为四类,即利尿剂,肾上腺素能抑制剂,转换酶抑制剂,血管扩张剂(包括钙通道阻滞剂).由于不同作用机制的降压药颇多,一般临床医师在使用时发生困难.美国“高血压检测、评价与治疗”联合委员会为此提出阶梯治疗指南,这成为美国心肺血液研究院“全国高血压教育方案”中推荐实施血压控制与管理的基础.该方案广为推行,获得惊人的成功.脑卒中死亡率在第一个10年中下降了42%.然而,由于对高血压各阶段各类型机理的知识不断增加,提示了阶梯的第一级治疗可能是一种陈旧的治疗方式, Modern Treatment of Hypertension Since 1951, two drugs, hydralazine and hexatriquat, have developed over 40 drugs that can be classified into four categories: diuretics, adrenergic inhibitors, Conversion enzyme inhibitors, vasodilators (including calcium channel blockers.) Because of the different mechanisms of action of a large number of antihypertensive drugs, the general clinicians in the use of difficulties. United States “Hypertension testing, evaluation and treatment of” joint The committee came up with a step-by-step guide to treatment, which became the basis for recommending blood pressure control and management recommended by the American Heart Lung Blood Institute, “National Hypertension Education Program.” The program was widely implemented and achieved phenomenal success. A 42% decrease in the first decade.10 However, as knowledge of the various types of mechanisms at various stages of hypertension continues to increase, it is suggested that first-level treatment of the ladder may be an obsolete treatment,