糖尿病合并高血压的可能机制和降压药选择策略

被引：23

作者：

张学明

机构：

[1] 甘肃省定西市人民医院

来源：

中国当代医药 | 2010年 / 17卷 / 06期

关键词：

糖尿病; 高血压; 血管紧张素转换酶抑制剂; 血管紧张素Ⅱ受体阻滞剂; β受体阻滞剂; 钙通道阻滞剂; 利尿剂;

D O I：

暂无

中图分类号：

R587.1 [糖尿病]; R544.1 [高血压];

学科分类号：

100201 [内科学];

摘要：

糖尿病合并高血压使患者心、脑血管事件和终末期肾病的发病危险明显增加。本文简述了糖尿病合并高血压的可能机制,并对糖尿病合并高血压患者的降压药选择进行了复习。目前的总体认识为:血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体阻滞剂、钙通道阻滞剂对糖代谢和糖尿病本身的作用为中性,甚至可产生一定的有益作用;而利尿剂、β受体阻滞剂则可能对糖代谢产生不利影响,特别是当两者合用时,但现有的研究资料尚不能明确证实某一类型降压药具有明显的优越性,因此,无论使用何种药物,使患者的血压迅速、稳定地控制在130/80mmHg以下才是最重要的目标。

引用

页码：13 / 15

页数：3

共 9 条

[1]

The metabolic syndrome in hypertension: European society of hypertension position statement [J].

Redon, Josep ;

Cifkova, Renata ;

Laurent, Stephane ;

Nilsson, Peter ;

Narkiewicz, Krzysztof ;

Erdine, Serap ;

Mancia, Giuseppe .

JOURNAL OF HYPERTENSION, 2008, 26 (10) :1891-1900

[2]

Beta-blockers have a beneficial effect upon endothelial function and microalbuminuria in African-American subjects with diabetes and hypertension [J].

Jawa, Ali ;

Nachimuthu, Senthil ;

Pendergrass, Merti ;

Asnani, Sunil ;

Fonseca, Vivian .

JOURNAL OF DIABETES AND ITS COMPLICATIONS, 2008, 22 (05) :303-308

[3]

Endothelial dysfunction in insulin resistance and type 2 diabetes [J].

Jansson, P.-A. .

JOURNAL OF INTERNAL MEDICINE, 2007, 262 (02) :173-183

[4]

Aldosterone as a key mediator of the cardiometabolic syndrome in primary aldosteronism: an observational study [J].

Giacchetti, Gilberta ;

Ronconi, Vanessa ;

Turchi, Federica ;

Agostinelli, Laura ;

Mantero, Franco ;

Rilli, Silvia ;

Boscaro, Marco .

JOURNAL OF HYPERTENSION, 2007, 25 (01) :177-186

[5]

Plasma aldosterone is independently associated with the metabolic syndrome [J].

Bochud, Murielle ;

Nussberger, Jurg ;

Bovet, Pascal ;

Maillard, Marc R. ;

Elston, Robert C. ;

Paccaud, Fred ;

Shamlaye, Conrad ;

Burnier, Michel .

HYPERTENSION, 2006, 48 (02) :239-245

[6]

Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39 [J].

Stearne, MR ;

Palmer, SL ;

Hammersley, MS ;

Franklin, SL ;

Spivey, RS ;

Levy, JC ;

Tidy, CR ;

Bell, NJ ;

Steemson, J ;

Barrow, BA ;

Coster, R ;

Waring, K ;

Nolan, L ;

Truscott, E ;

Walravens, N ;

Cook, BL ;

Lampard, H ;

Merle, C ;

Parker, P ;

McVittie, J ;

Draisey, I ;

Murchison, LE ;

Brunt, AHE ;

Williams, MJ ;

Pearson, DW ;

Petrie, XMP ;

Lean, MEJ ;

Walmsley, D ;

Lyall, F ;

Christie, E ;

Church, J ;

Thomson, E ;

Farrow, A ;

Stowers, JM ;

Stowers, M ;

McHardy, K ;

Patterson, N ;

Wright, AD ;

Levi, NA ;

Shearer, AGI ;

Thompson, RJW ;

Taylor, G ;

Rayton, S ;

Bradbury, M ;

Glover, A ;

Smyth-Osbourne, A ;

Parkes, C ;

Graham, J ;

England, P ;

Gyde, S .

BRITISH MEDICAL JOURNAL, 1998, 317 (7160) :713-720

[7]

EFFECTS OF LOW-DOSE VERSUS CONVENTIONAL-DOSE THIAZIDE DIURETIC ON INSULIN ACTION IN ESSENTIAL-HYPERTENSION [J].

HARPER, R ;

ENNIS, CN ;

SHERIDAN, B ;

ATKINSON, AB ;

JOHNSTON, GD ;

BELL, PM .

BRITISH MEDICAL JOURNAL, 1994, 309 (6949) :226-230

[8]

The Metabolic and Circulatory Response to Beta-blockade in Hypertensive Men is Correlated to Muscle Capillary Density.[J].Hans Lithell;Thomas Pollare;Christian Berne;Bengt Saltin.Blood Pressure.1992, 1

[9]

ACE-INHIBITION INCREASES HEPATIC AND EXTRAHEPATIC SENSITIVITY TO INSULIN IN PATIENTS WITH TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS AND ARTERIAL-HYPERTENSION [J].

TORLONE, E ;

RAMBOTTI, AM ;

PERRIELLO, G ;

BOTTA, G ;

SANTEUSANIO, F ;

BRUNETTI, P ;

BOLLI, GB .

DIABETOLOGIA, 1991, 34 (02) :119-125

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