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首页> 外文期刊>Journal of International Medical Research >Haemodynamic Abnormalities in Hypertensive Patients: A Review of the Influence of Vasodilating Drugs
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Haemodynamic Abnormalities in Hypertensive Patients: A Review of the Influence of Vasodilating Drugs

机译:高血压患者的血流动力学异常:血管舒张药物影响的综述

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Mean arterial pressure is determined primarily by cardiac output and total peripheral resistance, in addition to blood volume and compliance of the arterial system. The regulation of these determinants occurs via reflex neurogenic mechanisms and metabolic or humoral mechanisms. The haemodynamic situation in the early stages of arterial hypertension is characterized by a slight hypercirculatory state due to a moderate increase in heart rate and cardiac output, whereas the total peripheral resistance is increased only moderately, if at all. In later stages, however, a progressive increase in total peripheral resistance prevails, accompanied by a decrease in left ventricular performance due to the development of left ventricular hypertrophy, changes in ventricle geometry and coronary heart disease. A pharmacologically-induced decrease of total peripheral resistance by means of vasodilators, therefore, represents a logical approach to therapy, at least of advanced hypertension. Vasodilators can be classified into three categories: (1) those with preferential activity on the arterial resistance vessels, eg hydralazine, diazoxide, minoxidil; (2) those with preferential activity on venous capacitance vessels, eg organic nitrates; and (3) those with activities on both branches, eg sodium nitroprusside, urapidil, prazosin and other α-blockers. Brief reference is made to new and possibly more acceptable vasodilators – in particular carvedilol and prizidilol.
机译:平均动脉压除血容量和动脉系统顺应性外,主要由心输出量和总外周阻力决定。这些决定因素的调节通过反射神经发生机制和代谢或体液机制进行。动脉高血压早期的血液动力学状况的特征是由于心率和心输出量的适度增加而引起的轻微的高循环状态,而总外周阻力仅适度增加(如果有的话)。然而,在以后的阶段,总的外周阻力逐渐增加,由于左心室肥大的发展,心室几何形状的改变和冠心病,伴随着左心室性能的下降。因此,药理学上通过血管扩张剂引起的总外周阻力的降低代表了至少是晚期高血压治疗的合乎逻辑的方法。血管扩张剂可分为三类:(1)对动脉阻力血管具有优先活性的物质,例如肼屈嗪,二氮嗪,米诺地尔; (2)在静脉电容血管上有优先活性的那些,例如有机硝酸盐; (3)在两个分支上均具有活性的那些,例如硝普钠,尿嘧啶,哌唑嗪和其他α受体阻滞剂。简要介绍了新的并且可能是更可接受的血管扩张药,尤其是卡维地洛和普利西地洛。

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