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最新荟萃分析发现,肾素-血管紧张素(Ang)-醛固酮系统(RAAS)抑制剂能降低高血压患者死亡率,其治疗获益全部源于血管紧张素转化酶(ACE)抑制剂(ACEIs),而非血管紧张素受体拮抗剂(ARBs)。RAAS可以归纳为2条轴:ACE-AngⅡ(1-8)-AT1受体轴和ACE2-Ang(1-7)-Mas受体轴,ACEIs对RAAS的2条轴均发挥良好作用,而ARBs主要作用于前者。各个指南推荐高血压相关心血管疾病治疗优先选择ACEIs,对不能够耐受者选择ARBs。我们应当重视ACEIs在高血压、冠心病、心肌梗死和心力衰竭防治中的应用,目的是降低心血管疾病患病率和死亡率的风险。
The latest meta-analysis found that inhibitors of renin-angiotensin-aldosterone system (RAAS) can reduce the mortality of hypertensive patients, all of which benefit from the treatment of angiotensin-converting enzyme (ACE) inhibitors (ACEIs) , Rather than angiotensin receptor blockers (ARBs). RAAS can be summarized into two axes: ACE-AngⅡ (1-8) -AT1 receptor axis and ACE2-Ang (1-7) -Mas receptor axis. ACEIs play a good role on both axes of RAAS, while ARBs The main role in the former. Each guideline recommends ACE inhibitors for the treatment of hypertension-related cardiovascular disease and ARBs for those who are intolerant. We should pay attention to the use of ACEIs in the prevention and treatment of hypertension, coronary heart disease, myocardial infarction and heart failure in order to reduce the risk of cardiovascular disease morbidity and mortality.