文档介绍：第18章抗高血压药物Antihypertensive Agents
Hypertension
Background: Hypertension is one of the mon diseases afflicting humans throughout the world. Because of the associated morbidity and mortality and the cost to society, hyperten-sion is an important public health challenge.
Definition :Defining abnormally high blood pressure is extremely difficult and arbitrary. Furthermore, the relationship between systemic arterial pressure and morbidity appears to be quantitative rather than qualitative.
血压水平的定义和分类(WHO/ISH)
Difinition Systolic Diastolic
正常血压<140 and <90
Optimal* < 120 and < 80
Normal < 130 and < 85
High normal 130-139 or 85-89
高血压>=140 or >=90
Grade 1 - 140-159 or 90-99
Grade 2 - 160-179 or 100-109
Grade 3 - 180-209 or 110-119

⑴原发性高血压也称高血压病
是一种病因尚未明确,以动脉血压长期升高为主要表现的疾病。约占90以上。高血压病的发病率在我国已超过10%。
⑵继发性高血压也称症状性高血压
是某些疾病的一部分表现,如肾炎、肾动脉狭窄、嗜铬细胞瘤、皮质醇增多症、原发性醛固酮增多症、主动脉缩窄性病变(上肢血压增高而下肢血压降低)等。
,缓进型和急进型。
⑴缓进型高血压或称良性高血压(>95%)
起病隐匿,病程进展缓慢,达二三十年以上。对心、脑、肾等靶器官的损害缓慢进行,不易觉察。
⑵急进型高血压或称恶性高血压
病情严重,发展迅速,舒张压持续在130~140 mmHg以上,常于数月至1~2年内发生肾、脑、心并发症而死亡。
an Damage
Cardiovascular Disease 心
Heart diseases
Left ventricular hypertrophy
Angina pectoris /prior myocardial infarction
Heart failure
Stroke or transient ischemic attack 脑
Nephropathy 肾
Retinopathy 视网膜
Peripheral arterial disease 外周动脉
Pathogenesis of hypertension
The pathogenesis of essential hypertension is multifactorial and plex. Multiple factors modulate the blood pressure for adequate tissue perfusion and include humoral mediators, vascular reactivity, circulating blood volume, vascular caliber, blood viscosity, cardiac output, elasticity of the blood vessels, and neural stimulation.
A possible pathogenesis of essential hypertension is proposed whereby multiple factors, including ic predisposition, excess dietary salt intake, and adrenergic tone, may interact to produce hypertension. Although ics appears to contribute to essential hypertension, the exact mechanism has not been established