Chronic systolic heart failure, guideline-directed medical therapy, and systemic hypotension-less pressure but maybe more risk (does this clinical scenario need more discussion?).

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Chronic systolic heart failure, guideline-directed medical therapy, and systemic hypotension-less pressure but maybe more risk (does this clinical scenario need more discussion?).

机译：慢性收缩性心力衰竭，指导性药物治疗和全身性低血压无压力，但风险可能更大（这种临床情况需要更多讨论吗？）。

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Many clinical trials have demonstrated the survival benefit of medication regimens that modulate the neurohormonal activation that occurs with chronic heart failure (HF). These medications, however, also commonly lower systemic blood pressure (BP). Low arterial BP in patients with chronic HF has been shown to be an independent predictor of increased mortality. Given this apparent paradox in therapeutic goals (treat aggressively but keep BP from going too low), how low should we allow systemic BP to go as a result of our medication regimens before we compromise the proven benefits of such drug therapy? Or is the association between the BP-lowering effects of standard therapy and outcomes in HF even meaningful clinically? It is from this perspective that the merits, potential clinical implications, and the relevant published literature pertaining to this patient and practice management issue will be discussed.

机译：许多临床试验表明，用药方案可以调节慢性心力衰竭（HF）发生的神经激素激活，从而具有生存优势。但是，这些药物通常还可以降低全身血压（BP）。慢性HF患者的低动脉血压已被证明是死亡率增加的独立预测因子。鉴于治疗目标存在明显的悖论（积极治疗，但不要使BP降低过低），在我们折衷这种药物治疗已证实的益处之前，由于我们的药物治疗方案，我们应允许全身性BP降低多少？还是标准疗法的降血压效果与HF的转归之间的关联在临床上甚至有意义？从这个角度出发，将讨论有关该患者和实践管理问题的优点，潜在的临床意义以及相关的已发表文献。

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《Journal of cardiac failure》 |2009年第2期|共7页
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正文语种 eng
中图分类心脏、血管（循环系）疾病;
关键词
Antihypertensive Agents; Blood Pressure; Cardiotonic Agents; Chronic Disease; Heart Failure; Systolic; Humans; Hypotension; Practice Guidelines as Topic; Prognosis; Risk Assessment; Risk Factors;

机译：降压药;血压;强心药;慢性病;心力衰竭;收缩压;人类;低血压;实用指南;预后;风险评估;风险因素;

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1. Chronic systolic heart failure, guideline-directed medical therapy, and systemic hypotension-less pressure but maybe more risk (does this clinical scenario need more discussion?). [J] . Journal of cardiac failure . 2009,第2期

机译：慢性收缩性心力衰竭，指导性药物治疗和全身性低血压无压力，但风险可能更大（这种临床情况需要更多讨论吗？）。
2. Effect of Visit‐to‐Visit Variation of Heart Rate and Systolic Blood Pressure on Outcomes in Chronic Systolic Heart Failure: Results From the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) Trial [J] . Felix Mahfoud, Ian Ford, Jeffrey Borer, Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease . 2016,第2期

机译：访视时心率和收缩压变化对慢性收缩性心力衰竭结果的影响：if抑制剂伊伐布雷定试验（SHIFT）试验对收缩性心力衰竭的治疗结果
3. Evaluation of the prescribing practice of guideline-directed medical therapy among ambulatory chronic heart failure patients [J] . Daya Ram Parajuli, Sepehr Shakib, Joanne Eng-Frost, BMC Cardiovascular Disorders . 2021,第1期

机译：慢性心力衰竭患者指南指导医学治疗规定实践的评价
4. Clinical characteristics, management, and outcomes of patients with high risk chronic heart failure referred to a heart failure clinic in Saudi Arabia [C] . Waleed M.A. World Congress on Heart Disease. . 2013

机译：高危慢性心力衰竭患者的临床特征，管理和结果提及沙特阿拉伯的心力衰竭诊所
5. The effect of beta-blocker therapy, ACE inhibitor therapy, and digoxin therapy on the risk of hospitalization and resource utilization among patients with congestive heart failure enrolled in a managed care organization. [D] . Abarca, Jacob. 2001

机译：在管理性医疗机构中，充血性心力衰竭患者的β受体阻滞剂治疗，ACEI抑制剂治疗和地高辛治疗对住院风险和资源利用风险的影响。
6. Effect of Visit‐to‐Visit Variation of Heart Rate and Systolic Blood Pressure on Outcomes in Chronic Systolic Heart Failure: Results From the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) Trial [O] . Michael Böhm, Michele Robertson, Jeffrey Borer, 2016

机译：访视时心率和收缩压变化对慢性收缩性心力衰竭结果的影响：I收缩期心力衰竭治疗的结果f抑制剂伊伐布雷定试验（SHIFT）试验
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机译：心力衰竭：左心室收缩功能障碍患者的评估和护理。临床实践指南第11号;心力衰竭：左心室收缩功能障碍患者的治疗。临床医生快速参考指南第11号;与心脏病共存：是心衰吗？患者和家庭指南

Chronic systolic heart failure, guideline-directed medical therapy, and systemic hypotension-less pressure but maybe more risk (does this clinical scenario need more discussion?).

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