高血压研究四十年

为探讨我国高血压的发病情况,研究高血压的防治和发病机制,中国医学科学院阜外医院高血压研究室与流行病学研究室,基础医学研究所生理学系及药物研究所药理学研究室自1959年始陆续开展了全国高血压流行病学调查和人群防治试点、高血压治疗研究、高血压发病机制研究和中药降压作用研究。研究结果表明:(1)我国高血压的患病率逐年增高,自1959年的5.11%,上升至1979年的7.73%和1991年的11.26%。但患者的知晓率仅26.3%,治疗率仅12.1%,控制率仅2.8%。体重超重和经常饮酒是我国高血压的危险因素,高钠、低钾、低钙及低蛋白饮食是血压升高的因素。我国人群中血压升高是冠心病和脑卒中发病的最重要危险因素。(2)建立了我国高血压诊断和分期标准。发现在我国高血压患者中继发性高血压仅占1.1%。率先提出了大动脉炎的概念并发现大动脉炎是肾性高血压的主要原因。对患者进行身心教育调动其主观能动性,加以低剂量的复方降压制剂有效地促进了群防群治工作的开展。大样本多中心随机对照临床实验证实,对高血压性脑卒中和心肌梗死的治疗可明显降低其再发和死亡危险。(3)对实验性高血压大鼠阻力动脉平滑肌收缩机制研究证明,血管平滑肌细胞Ca2 转运、利用、代谢及其调控因素均发生一系列变化,并具有遗传因素,这是血液循环外周

A forty-year study on hypertension

1.Department of Hypertension,Fu Wai Hospital,Beijing100037;2.Department of Physiology,Institute of Basic Medical Sciences,Beijing100005;3.Department of Pharmacology,Institute of Materia Medica,Beijing100050;4.Department of Epidemiology,Fu Wai Hospital,Beijing100037; Since1959the investigations on prevalence of hypertension and studies on the prevention and treatment of this disease have been carried out.The vascular mechanism of hypertension and the depressor effect of Chinese traditional herbs were also studied in Chinese Academy of Medical Sciences.The results revealed that:(1)The prevalence of hypertension in Chinese adults increased from7.73%in1979to11.26%in1991,both much higher than that in1959(5.11%).The rate of awareness,treatment and control was only26.3%,12.1%,and2.8%respectively.The risk factors of hypertension included overweight and alcohol drinking.High sodium,low potassium,low calcium,and low animal protein diet were also very important risk for elevation of blood pressure.Hypertension was the most important causal risk factor of coronary heart disease and stroke.(2)Hypertension diagnosis and staging criteria were established in1959.Secondary hypertension was found to constitute1.1%among community hypertensive patients.The new concept of aortitis was formed and found to be the most common cause of renal vascular hypertension.Patient education together with low dose compounds of antihypertensive drugs was implicated widely.Randomized clinical trials Syst-China,Post-stroke Antihypertensive Treatment Study,Chinese Acute Stroke Trial,and Chinese Cardiac Study1demonstrated benefits of treatment for hypertensive,stroke or acute myocardial infarction affordable by Chinese population at large.(3)A series of functional changes and abnormalities with evident hereditary characteristics were found in the processes of cellular Ca 2 transportation,utilization,metabolism and their modulation of the vascular smooth muscle in SHR,and SHRsp,which seem to be the principal cause of the increase in peripheral vascular resistance in hyp ertension.(4)Alkaloid of Rauwolfia verticilata and Ligustrazine had marked depressor effect.Flavones of Radix Pueraricae could reduce the cardiac and cerebral ischemic damage and symptoms in hypertensive patients.