2024 年第 5 期 第 0 卷

高血压合并心力衰竭一线降压药物治疗的研究进展

Research progress of first-line antihypertensive drug therapy for hypertension complicated with heart failure

作者：廖乾莉1 范小春2,3

英文作者：Liao Qianli1 Fan Xiaochun23

单位：1四川大学华西医院全科（特需）病房，成都610041；2四川省南充市中医医院筋骨病中医药防治南充市重点实验室，南充637000；3川北医学院医学影像四川省重点实验室，南充637000

英文单位：1General (Special needs) Ward West China Hospital Sichuan University Chengdu 610041 China; 2Nanchong Key Laboratory of TCM Prevention and Treatment of Muscle and Bone Diseases Nanchong Hospital of Traditional Chinese Medicine Sichuan Province Nanchong 637000 China; 3Sichuan Provincial Key Laboratory of Medical Imaging North Sichuan Medical College Nanchong 637000 China

关键词：高血压；心力衰竭；一线降压药物；射血分数

英文关键词：Hypertension;Heartfailure;First-lineantihypertensivedrugs;Ejectionfraction

• 摘要：

• 降压药物治疗是伴发心力衰竭的高血压患者重要干预手段，血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、血管紧张素受体脑啡肽酶抑制剂、利尿剂、钙通道阻滞剂及β受体阻滞剂是临床目前常用一线降压药物。对于高血压合并心力衰竭这类高危患者，临床普遍采取多种药物联合治疗方案，且不同左心室射血分数分级患者降压药物疗效存在差异，因此，使用降压药物前对高血压患者心血管病变情况进行分层将有利于指导临床进行合理用药。本文就最新一线降压药物对于高血压合并心力衰竭的治疗效果及研究进展进行综述。

• Antihypertensive drug therapy is an important intervention for hypertensive patients with heart failure. Angiotensin converting enzyme inhibitor, angiotensin Ⅱ receptor blocker, angiotensin receptor neprilysin inhibitor, diuretic, calcium channel blocker and β-receptor blocker are commonly used as first-line antihypertensive drugs in clinical practice. For high-risk patients with hypertension and heart failure, multi-drug combination therapy is generally adopted in clinical practice, and the efficacy of antihypertensive drugs is different in patients with different left ventricular ejection fraction grades. Therefore, the stratification of cardiovascular disease in hypertensive patients before the use of antihypertensive drugs will be helpful to guide clinical rational drug use. This article reviews the therapeutic effect and research progress of the latest first-line antihypertensive drugs for hypertension complicated with heart failure.