5 高血圧(シンポジウム 生活習慣病 : 臓器障害と治療のEBM,第609回新潟医学会)

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概要

• 論文の詳細を見る

• Recent large number of studies revealed that anti-hypertensive therapy had several fruitful effects on the prevention of various organ damage. As the undesirable effects of hypertension on organ damages were different between patients with only hypertension and ones with both hypertension and metabolic syndrome, effects of anti-hypertensive therapy should be analyzed by dividing these two types of patients mentioned above. Multiple Risk Factor Intervention Trial demonstrated that cardiovascular death rates in men with diabetes were approximately two times as many as those in men without diabetes when levels of blood pressure were adjusted to the same. Thus, various organs in diabetic patients were sensitive to influence of blood pressure. Although the exact reason of this phenomenon still remains unclear, one possible explanation is that this phenomenon may be resulted from impaired antoregulation of various organs which was induced by long term hyperglycemia. What kinds of changes in frequency of diabetic complications were induced by anti-hypertensive therapy in diabetic patients? Frequency in severe diabetic complications including nephropathy and retinopathy was reduced from approximately 30% to 12〜13% in IDDM patients at 20 years after onset of diabetes by aggressive anti-hypertensive therapy. Furthermore, survival of type 1 diabetes with nephropathy has remarkably improved after early use of effective anti-hypertensive treatment has became routine. The nephroprotective effect of renin-angitensin system (RAS), inhibition of the development of type 2 diabetes by blockade of RAS, prevention of pneumonia in older patients by ACEI and preservation of cognition in Alzheimer disease by brain-penetrating ACEI were introduced as new trials of drugs which inhibited renin-angotensin system.

• 新潟大学の論文
• 2005-11-10

著者

• 伊藤 正毅

  秋田大学医学部

• 伊藤 正毅

  秋田大学 医学部内科学講座内分泌・代謝・老年医学分野

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• 5 高血圧(シンポジウム 生活習慣病 : 臓器障害と治療のEBM,第609回新潟医学会)
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