鹤鸣培训：遵循指南强化降压—提高基层高血压的防治水平.pptVIP

（按ppt内容讲解）0号发明人之一洪昭光教授这样评价0号： 0号发明30余年了，从最开始为高干使用，现在变成中国老百姓使用最多的降压药，一定有它的合理性，不是每个药都能经久不衰的； 0号是经过时间考验的经典用药，具有中国特色；现在国外才开始采用复方制剂，我国在30年前就有了复方制剂，所以说0号走在世界前列。 * （按ppt内容讲解）世界高血压联盟主席刘力生教授对0号的评价：降压比不降压好，服长效降压药比服短效降压药好；联合用药是未来高血压治疗的趋势；0号采用相对合理的组方，降压效果确切、依从性高；适合中国广大社区、城镇、农村患者使用。 * * 2010指南P36-40 血压正常了就可以停药？ No! 降压药物只降高血压，不降正常血压 早上药要吃过早饭才能服？ No! 睁眼即服 药物要经常更换，否则就无效了？ No! 降压药永远有效，只是季节，环境变化而血压有变 * * * * * * * 联合治疗也符合高血压的发病机制： 高血压的发病与交感神经系统和RAAS系统激活、体液总量的增加有关，而且主要发病机制存在个体差异。 单药治疗的缺陷之一就是只能作用于高血压发病机制的某一方面，不能全面控制血压。 * 2010年指南P25,2009年基层版P10。 在临床治疗时，治疗流程中对于血压160/100mmHg 低危患者，在第一步先使用单药进行治疗，效果不佳后才选择使用联合用药或者复方制剂。临床上应根据患者具体情况选择用药，有可能第一步即可选择使用低剂量固定复方制剂进行治疗。 * * 我国高血压患者的服药依从性需要进一步提高，40.5%的患者存在药物漏服的情况。 * * One of the key advantages of fixed versus free combinations is that of simplicity of treatment: a single pill provides a more convenient means of managing hypertension, especially considering that these patients may also be taking other medications for concomitant cardiovascular risk factors. Convenience and simplicity of treatment through a reduced pill burden supports improved compliance to medication. This is a particularly important point because non-compliance is a major problem among patients with hypertension and is one of the main causes of failure to adequately control BP.1 Improved compliance is likely to translate into health-economic benefits:2 Fixed combinations are likely to cost less than the individual components prescribed separately and costs associated with managing high BP and its associated complications are likely to be reduced owing to improvements in medication-taking behavior. Another advantage concerns that of an improved tolerability profile owing to the generally lower doses used in fixed combinations. References 1. Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy. Am J Hypertens 2006;19:1190–6. 2. Neutel JM. Fixed combination antihypertensive therapy. In: Oparil S, Weber MA, edito