的降压药物或联合用药的最佳方案

,,,,,2009-07-04::,150001:[e-mail]:1005-2194(2009)09-0789-03,,:R5:A,,,,10,1,1,10,100,SCI30:,,D1-T,:;;Thenewprogressintreatmentofhypertension.LIWei2min,LIUBin,ZHANGXiao2wei.TheFirstClinicalHospitalofHarbinMedicalUniversity,Harbin150001,ChinaSummary:Inordertoachievehighqualityantihypertens2iveeffect.Itpsnecessarytodevelopnewantihypertensivedrugs.Thispaperexpoundsnewantihypertensivemedications,inclu2dingthemechanismofaction,thedrugcharacteristicsandrep2resentativesofnewantihypertensivemedications,suchasselec2tivealdosteronereceptorantagonist,D1receptoragonist,endo2peptidase2angiotensinconvertingenzymeinhibitor,renininhibi2tor,endothelinreceptorblockers,potassiumchannelopener,ni2trogenmonoxidum,T2calciumchannelblockers.Hypertensionisapolygenicinheritancediseaseandgenetherapyisahotspotofcurrentlyhypertensiontreatmentresearch.Thispaperintro2ducestheresearchprogressofgenetherapyofhypertension.Keywords:hypertension;antihypertensivedrug;genether2apy,,,30%,62%49%,,[1],,,1:(eplerenone)(),,,,,1520,500,[2][3],,,,,(ACEI)(ARB),2D1:(fenoldopam)G,,D1D2D1D1D5,GSGolfD2D2D3D4,GGiGo,,D1D198720099299D1,,;:(918min);,;,,,(FDA)3-(NEP2ACE)(ANP),NEPANP,ANP,NEPACE,NEP2ACEACE,Ang;NEP,ANP(AM),,cAMP(omapatrilat)fasdotrilatsam2patrilat,,,,4:(aliskiren)RAS,AngAng,AngGACEAT1AT2P,,ALLAY,,RAASALLAY,[4],5:(bosentan)(ET)ETAETB,ETAETB,,[5]ETETAETB,,,6(PCOs)(PCOs)K+,K+,,PCOsATPK+,10100,PCOs,;,;;[6]7(NO)NO,;NONO,,8T:(mibefradil)L2T2L2T2,T2,T2T2,TL30100L2,T,,,,,,,,T2[7]9,()(),,ANP(NOS)(AS2cDNA),mRNA,[(angiotensin,Ang)],097ChineseJournalofPracticalInternalMedicineSep.2009Vol.29No.9()1[8-9],,,,,,,,,,,,,[1]ManciaG,DeBackerG,DominiczakA,etal.2007Guidelinesforthemanagementofarterialhypertension:TheTaskForcefortheManagementofArterialHypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].EurHeartJ,2007,28(12):1462-1536.[2]KaragiannisA,TziomalosK,PapageorgiouA,etal.Spironolactoneversuseplerenoneforthetreatmentofidiopathichyperaldosteron2ism[J].ExpertOpinPharmacother,2008,9(4):509-515.[3]WeirRA,MarkPB,PetrieCJ,etal.Leftventricularremodelingaf2teracutemyocardialinfarction:doeseplerenonehaveaneffect?[J].AmHeartJ,2009,157(6):1088-1096.[4]SolomonSD,AppelbaumE,ManningWJ,etal.EffectofthedirectRenininhibitoraliskiren,theAngiotensinreceptorblockerlosar2tan,orbothonleftventricularmassinpatientswithhypertensionandleftventricularhypertrophy[J].Circulation,2009,119(4):530-537.[5]TranLT,MacLeodKM,McNeillJH.Endothelin21modulatesan2giotensininthedevelopmentofhypertensioninfructose2fedrats[J].MolCellBiochem,2009,325(1-2):89-97.[6]ZlatkovicJ,ArrellDK,KaneGC,etal.ProteomicprofilingofKATPchannel2deficienthypertensiveheartmapsriskformaladap2tivecardiomyopathicoutcome[J].Proteomics,2009,9(5):1314-1325.[7]BallCJ,WilsonDP,TurnerSP,etal.HeterogeneityofL2andT2channelsinthevasculature:rationalefortheefficacyofcombinedL2andT2blockade[J].Hypertension,2009,53(4):654-660.[8]UlfhammerE,CarlstrÊmM,BerghN,etal.Suppressionofendothe2lialt2PAexpressionbyprolongedhighlaminarshearstress[J].BiochemBiophysResCommun,2009,379(2):532-536.[9]PetersonSJ,FrishmanWH.Targetinghemeoxygenase:therapeuticimplicationsfordiseasesofthecardiovascularsystem[J].CardiolRev,2009,17(3):99-111.2009-06-29::,[e-mail]:1005-2194(2009)09-0791-05,:R5:A,:,,;,,:;Diagnoseandtherapyofsecondaryhypertension.GONGYan2chun,QIWen2hang.ShanghaiJiaotongUniversity,RuijinHospital,Shanghai200025,ChinaSummary:Highbloodpressurehasreceivedabundantclinicalandlaboratoryattentioninrecentyears.Thechiefcau2sesofhypertensionsecondarytorenalandadrenallesionshasincreased.Investigationofhypertensionforanunderlyingcausewillrevealasmallnumberofpatientswithtreatabledisorders,ofwhomafewwillbecuredbyspecificintervention.Drugther2apyofsecondaryhypertensionhasreachedanewstageofeffec2tivenessandspecificity,andmanypatientscanbesuccessfullymanagedmedically.Thechiefindicationsforsurgicalinterven2tionarerenalarterystenosisingood2riskindividualswithdefi2nitecriteriaofrenalischemia,pheochromocytoma,andprimaryaldosteronism,andamoderatenumberwithirreversiblediseasewhoareathighriskofmyocardialinfarctionandstroke.Keywords:hypertension;secondaryhypertension,2,90%(),10%(),,,,19720099299