58 2013 5 4

20 5 [4] 30%[5]
60 2007 2009
13 078 60%
61.9%[6]
2006 2007 EU-ROASPIRE
[1]
Lindholm 87.5%
2006 NICE [7]
[2]



1.3
1 2005 Lindholm Lindholm
1.12010
4 [ [1] NICE
CCB Lindholm
ACEIARB ]
5 1
24 [8]




[3]

1.2
[9]

Email nlsun@263.net

www.medlive.cn
2013 5 4 59

2.2.2
2 MAPHY[17]MRC-2[18]IPPPSH[19]STOP-
2.1 Hypertension[20] CONVINCE[21]

- RAS 147

CCBACEIARB
[22]
LIFE [23] ASCOT-BPLA
[24]
2.2
2.2.1 1292 LIFE ASCOT-
BPLA
[10] [11]
GENRES 208 Lindholm
5 mg [1]
5 mg 25 mg 50 mg 4
24 11/8 mm Hg1 16% 95%CI 4% 30%
mm Hg 0.133 kPa
7/5 mm Hg5/2 mm Hg
[12]
9/6 mm HgBRIGT 2161
12 PWV
25.29 mm Hg 14.14
mm Hg 96.44% [25] 2

2.2.3
1


1 2

1


W mg mm Hg mm Hg /
5 102 / vs. 149.7/97.6 135.4/85.6 11.7
277 4
[13] 25 502 / 150.5/98.1 138.0/88.8 10.7

10 2 / vs. 153.3/100.5 132.5/86.6 5.9

194 8
25 502 / 151.7/99.1 135.5/86.7 7.6
[14]
2.5 7.51 / vs. 152.9/98.2 131.5/82.2 9.2
220 8
[15] 25 752 / 149.2/97.8 131.5/81.9 8.1
10 202 / vs. 153.8/99.8 137.3/87.8 6
399 4
399 [16] 50 1002 / 156.8/100.5 46.3/91.5 6

www.medlive.cn
60 2013 5 4

2

MRC-1 4369 5.8 Atenololdiuretic vs. PL 25% 19% 17%
MAPHY 3234 5.0 Metoprolol vs. HCTZ P 0.028
P 0.048P 0.017
IPPPSH 6357 4.0 Oxprenolol vs. PL 17%
CONVINCE 16 476 3.0 Atenolol vs. verapamil HR 1.02 P 0.77
UKPDS[26] 758 9.0 Atenolol vs.captopril HR 1.14 P 0.44
NORDIL [27]
10881 4.5 Any -blocker vs.diltiazem
P 0.04
ELSA[28] 2334 3.8 Atenolol vs.lacidipine
INVEST[29] 22576 2.7 Atenolol vs. verapamil 10.17%
vs.9.93%
LIFE 9193 4.8 Atenolol vs. Losartan 13% 25%
ASCOT-BPLA 19 257 5.7 Atenolol vs. Amlodipine 23% P 0.0003
25%P 0.0001
Atenolol diuretic PL Metoprolol HCTZ Oxprenolol
verapamil Losartan Amlodipine ;lacidipine: captopril

[30]
,
24
1 NO

24 [35, 36]

[31]

3 2011

80 mg/d [37]
[32]
100 mg/d 3
5 mg/d 50 100 mg/d 3.1
1 [38]
3.1.1 1 2
[33]
P 0.01
4 2
145 811

RR 0.9795% CI 0.88 1.07 3.1.2 1 1
RR 1.0695% 2
[34]
CI 1.01 1.10
3.1.3
5 1
3

www.medlive.cn
2013 5 4
61

NO 3.2.2

3.2 [38]
3.2.3
3.2.1

1

3
1 1
% %

6 10 0 10 50 60 + -
10 12 10 90 + -
50 60 40 50 + -
34
12 24
67 60 75 30 - +
10 12 0 85 - +
12 19 70 12 96 + -

3 1 2
3.3 [43]
3.3.1 3.3.4
1 1
78% 1 24 2

2
3.3.5
1
[39]
3 NO
3.3.2 2
ISA

70% CYP2D6 CYP2D6
1 [44]
4
[40,41]

CYP2D6* 10 4.1 5
[42]

1 2

24 1 CCB CCB
3.3.3
1
2010

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62
2013 5 4

4065

61 70 / 80 4.2
/ 39%
4.2.1
[45]
70 / LIFE
84 / 84 / REACH
1.59
[46]VALUE 1 [50]
80 / [51]
53% BP 140/90 mm Hg
[47]
34% 2011
[37]
70 /
1
4.8
J 60 75 / 2012 ST
[48]
1
A[52]2010 ST
24
1B[53]2012
[49] AHA
1A
1B
ACEI ARB ACEI [54] INVEST
22 576

75 / 5
/ 6%[29]

140/90 mm Hg
60 75 / 55 60 /
20 /
50 / [55]
ACEI ARB
4.2.2

HFPEF

75 / 75 / 70% HFPEF
CCB
ACEI ARB

1

ACEI ARB
CCB ARBACEI

www.medlive.cn
2013 5 4 63

HFPEF [56]OPTIMAIZE-HF 10 mg 200 mg

HFPEF 150 mg 50 mg
[57]

[58]
HFPEF 2012
HFPEF 55 60 / 55 /
[59]
2
4.2.3
70 / 70 /

3
[60]
CIBIS MERIT-HF[61] COPERNICUS[62] 50 60 / 55 60 /

1
130 80 mm Hg
34% 35% 41% 44%

ACEI ARB

MDC [63] ACEI ARB

5
2007 5.1
[64]
SENIORS 75 /

[65]

5.2

NYHA
NYHA B
[ LVEF 40%] 5.3
[66]

75 /

1.25
mg 1 12.5 mg 1
6.25 mg 2 3 60 75 /
3.125 mg 2 2 4 5.4
55 /
CCB

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64
2013 5 4

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