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[ESC 2010巅峰对话]王继光教授:哪些患者最适于接受奥美沙坦为基础的治疗?(二)

作者:  王继光   日期:2010/11/19 15:07:49

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《国际循环》:王教授您好,感谢您接受《国际循环》的专访,请您谈一下奥美沙坦适用于哪些高血压患者的治疗?

  《国际循环》:王教授您好,感谢您接受《国际循环》的专访,请您谈一下奥美沙坦适用于哪些高血压患者的治疗?
  Prof. Wang Ji Guang: When you have a patient who is untreated normally they would take 2 major classes of antihypertensive drugs. These may include calcium channel blockers and the other one is RAS blockade as well as ACE inhibitors or ARBs. You may choose one of the two major classes of antihypertensive drugs according to some basic characteristics such as age and ethnicity as the British NICE Guidelines state. So, when we have the untreated patient we would prescribe one of the two major classes of anti hypertensive drugs. In the younger patient we would prefer to use ARBs and in the slightly older patient population such as the 55-60 year old group we would prefer to prescribe calcium channel blockers. Olmesartan is one of the efficacious ARBs, which can produce a very good blood pressure reduction in hypertensive patients and so you can prescribe this drug to younger patients as the first line drug but you may also use this as a second line drug or during remission therapy when a patient has already taken a calcium channel blocker for instance such as amlodipine. Amlodipine is one of the very useful drugs for low hypertensive patients in the Eastern Asian population and so you may have a good chance to add an ARB such as olmesartan for instance to patients who have already taken a calcium channel blocker. It means that the drug olmesartan and other ARBs could be used either as monotherapy in many patients, young patients and those with target organ damage such as left ventricular hypertrophy, microalbuminuria and of course for diabetic patients
  王继光教授:对未经正规治疗的患者,有2种抗高血压药物可供选择,包括钙通道阻滞剂和RAS阻断剂,也就是ACEI和ARBs。根据英国NICE指南的推荐,可依据年龄、种族等基本特征从这两种主要抗高血压药物中进行选择。因此,对未经治疗的患者我们可以从2类抗高血压药物中选择一种。对年轻患者我们倾向于选择ARBs,老年患者人群可优先选择钙通道阻滞剂。奥美沙坦是一种非常有效的ARB,可产生非常好的降压效应,可作为年轻患者的一线药物;当患者已接受CCB如氨氯地平治疗时,奥美沙坦也可作为二线用药。氨氯地平是对东亚人群非常有效的一种降压药物,因此我们可以对已接受CCB治疗的患者加用ARB如奥美沙坦。这意味着奥美沙坦及其他ARBs可作为单药治疗用于年轻患者和靶器官损害如左室肥厚、MAU和糖尿病患者。

 

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