收缩压140-159或舒张压90-99 第二期高血压
收缩压160-179或舒张压100-109 第三期高血压
收缩压≥180或舒张压≥110 无危险因子 低度危险 中度危险 高度危险 1-2个危险因子 中度危险 中度危险 超高度危险
(含)3个危险因子以上,糖尿病或标的器官损伤 高度危险 高度危险 超高度危险 合并相关临床疾病 超高度危险 超高度危险 超高度危险 表(四)口服降压剂
ARCH INTERN MED/VOL 157, NOV 24, 1997;JAMA VOL 289,2003 药名 商品名
每日剂量范围(一天服用次数) 副作用 利尿剂
?○1Thiazide diuretics Hygroton Hydrodiuril, Dichlotride Natrilix Mykrox 12.5-50 (1) 12.5-50 (1) 1.25-2.5 (1) 0.5-1.0 (1)
短期:降低血清钾,钠,镁,增加尿酸,钙,胆固醇及血糖,很少引起发疹,对光敏感,胰脏炎,低纳血症,血性恶痛质(blood dyscrasias) (几乎不引起血糖及血脂变化) Chlorthalidone (G) Hydrochlorothiazide (G)
Indapamide Metolazone ○2Loop diuretics Bumetanide (G) Ethacrynic acid Furosemide (G) Bumex Busix Edecrin Lasix 0.5-4 (2-3) 25-100 (2-3) 40-240 (2-3)
(作用期间短,不会高钙血症) (耳毒性作用)
(作用期间短,不会高钙血症) ○3Potassium-sparing agents Amiloride hydrochloride (G) Triamterene (G) Midamor Dyrenium 5-10 (1) 25-100 (1) 高血钾症
(男性女乳化)男女皆然
?○4Adosterone-receptor blockers Spironolactone(G) Aldactone 25-100(1) 交感神经抑制剂 ○1作用在末梢神经 Guanethidine monosulfate Reserpine (G) Ismelin Serpasil 10-150 (1) 0.05-0.25 (1)
(姿位性低血压;腹泻,徐脉) (鼻塞,镇静,忧郁及活化消化性溃疡) ○2中枢α2活化剂
Clonidine hydrochloride (G) Guanfacine hydrochloride (G) Methyldopa (G) Catapres
Tenex Aldomet 0.2-1.2 (2-3) 1-3 (1) 500-3000 (2)
镇静,口乾,徐脉,戒断性高血压 (比较会戒断性高血压) (比较少会戒断性高血压) (肝病及自体免疫疾病) ○3α1交感神经阻断剂 Doxazosin mesytate Prazosin hydrochloride (G) Terazosin hydrochloride Doxaben Minipress Hytrin 1-16 (1) 2-30 (2-3) 1-20 (1) 姿位性低血压 ○4β交感神经阻断剂 非心脏选择性作用
Propranolol hydrochioride (G) Nadolol (G) Timolol maleate (G) Inderal Corgard Blocadren 10-480 (2) 40-320 (1) 20-60 (2)
支气管气喘,徐脉,心衰竭,可能掩饰低血糖症.比较轻微反应,有周边血液循环不良,失眠,疲倦,减少运动耐受性;除含ISA外,引起血中三酸甘油脂增加 心脏选择性作用 Atenolol (G)§
Betaxolol hydrochloride§ Bisoprolol fumarate§ Metoprolol tartrate (G)§ Metoprolol succinate§ Tenormin Kerlone Zebeta Concor Betaloc Toprol-XL
25-100 (1-2) 5-20 (1) 2.5-10 (1) 50-300 (2) 50-300 (1)
含intrinsic sympathomimetic activity Acebutolol§||
Carteolol hydrochloride|| Pindolol(G)11 Sectral Cartrol Visken 200-800 (1) 2.5-10 (1) 10-60 (2)
○5合并α,β 阻断剂 Carvedilol
Labetalol hydrochloride (G) Dilatrend Trandate 12.5-50 (2) 200-1200 (2)
姿位性低血压及支气管气喘 直接血管扩张剂 头痛,频脉,体液滞留
Hydralazine hydrochloride (G) Minoxidll (G) Apresoline Loniten 50-300 (2) 5-100 (1) (狼疮症侯群) (多毛症) 钙离子拮抗剂
○ANondihydropyridines (non DHP) Diltiazem hydrochloride Verapamil hydrochloride ○BDihydropyridines(DHP) Amlodipine besylate Felodipine Isradipine
Nicardipine hydrochloride Nifedipine Nisoldipine
Cardizem SR Cardizem CD Isoptin SR Verelan Norvasc Plendil DynaCirc Cardene SR Procardia XL Sular Syscor 120-360 (2) 120-360 (1) 90-480 (2) 120-480 (1) 2.5-10 (1) 2.5-20 (1) 5-20 (2) 60-90 (2) 30-120 (1) 20-60(1)
小心传导障碍,加重收缩性心衰竭 (呕心,头痛) (便秘)
足踝水肿,潮红,头痛 注:勿与葡萄柚汁合用 血管张力素转化酉每抑制剂 Benazepril hydrochioride Captopril (G) Enalapril maleate Fosinopril sodium Lisinopril Moexipril
Quinapril hydrochloride Ramipril Trandolapril Lotensin Capoten Vasotec Monopril Prinivil,Zestril Univasc Accurpril Altace Mavik