冯颖青,李勇,张宇清,王浩,陈源源,孙忠实,李悦,王鸿懿,谢良地,高平进,李南方,孙英贤,李新立,严晓伟,陈晓平,赵连友,孙宁玲

• 1:中国医师协会高血压专业委员会

摘要(Abstract)：

<正>β肾上腺素能受体阻滞剂(β阻滞剂)自20世纪60年代以来已广泛用于心血管疾病,首先用于高血压的治疗,继而在冠心病、心力衰竭、心律失常、心肌病的治疗中发挥了极其重要的作用。β阻滞剂在高血压临床治疗中适应证明确,疗效肯定,但因受到"β阻滞剂风波—Lindholm荟萃分析[1]

关键词(KeyWords)：

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 冯颖青,李勇,张宇清,王浩,陈源源,孙忠实,李悦,王鸿懿,谢良地,高平进,李南方,孙英贤,李新立,严晓伟,陈晓平,赵连友,孙宁玲

参考文献(References)：

• [1]Lindholm LH,Carlberg B,Samuelsson O.Should beta blockers remain first choice in the treatment of primary hypertension/A meta-analysis[J].Lancet,2005,366(9496):1545-1553.
• [2]Sever P.New hypertension guidelines from the National Institute for Health and Clinical Excellence and the British Hypertension Society[J].J Renin Angiotensin Aldosterone Syst,2006,7(2):61-63.
• [3]中国高血压防治指南修订委员会.中国高血压防治指南(2010)[J].中国医学前沿杂志(电子版),2011,3(5):42-93.
• [4]武阳丰,王增武,高润霖.中国医疗卫生人员高血压防治观念和防治知识调查[J].中华心血管病杂志,2004,32(3):264-269.
• [5]Wolf M,Heuten HG,De Swaef A,et al.The evolution of hypertension treatment in Belgium,a pharmacoepidemiological study[J].Acta Cardiol,2012,67(2):147-152.
• [6]张海波,张丹,李静,等.β受体阻滞剂在中国高危冠心病患者中的应用现状调查[J].临床心血管病杂志,2011,27(6):422-425.
• [7]Pajak A,Jankowski P,Kawecka-Jaszcz K,et al.Changes in secondary prevention of coronary artery disease in the post-discharge period over the decade1997-2007.Results of the Cracovian Program for Secondary Prevention of Ischaemic Heart Disease and Polish parts of the EUROASPIREⅡandⅢsurveys[J].Cardiol Pol,2009,67(12):1353-1359.
• [8]Neutel JM,Schnaper H,Cheung DG,et al.Antihypertensive effects of beta-blockers administered once daily:24-hour measurements[J].Am Heart J,1990,120(1):166-171.
• [9]张丹,李静,李希,等.β受体阻滞剂在中国高危冠心病患者中的应用现状调查[J].临床心血管病杂志,2011,27(6):422-425.
• [10]Materson BJ,Reda DJ,Cushman WC.Am J Hypertens.Department of veterans Affairs single-drug therapy of hypertension study.Revised figures and new data.Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents[J].Am J Hypertens,1995,8(2):189-192.
• [11]Suonsyrj T,Hannila-Handelberg T,Paavonen KJ,et al.Laboratory tests as predictors of the antihypertensive effects of amlodipine,bisoprolol,hydrochlorothiazide and losartan in men:results from the randomized,double-blind,crossover GENRES Study[J].J Hypertens,2008,26(6):1250-1256.
• [12]Channaraya V,Marya RK,Somasundaram M,et al.Efficacy and tolerability of aβ-1selectiveβblocker,bisoprolol,as a first-line antihypertensive in Indian patients diagnosed with essential hypertension(BRIGHT):an open-label,multicentric observational study[J].BMJ Open,2012,2(3):e000683
• [13]党爱民,刘国仗,蔡迺绳.盐酸阿罗洛尔对中青年高血压的降压疗效[J].中华高血压杂志,2011,19(2):163-166.
• [14]赵秀丽,胡大一,孙宁玲,等.卡维地洛与美托洛尔治疗原发性轻中度高血压的多中心临床研究[J].中华高血压杂志,2006,14(4):314-316.
• [15]石湘芸,赵勇,谢晋湘,等.比索洛尔与美托洛尔治疗高血压病疗效的对比研究[J].高血压杂志,2003,11(4):340-344.
• [16]郭冀珍,邵剑华,潘其兴,等.卡维地洛与拉贝洛尔治疗轻、中度高血压病399例的比较[J].中国新药与临床杂志,2000,19(2):81-84.
• [17]Wikstrand J,Warnold I,Olsson G,et al.Primary prevention with metoprolol in patients with hypertension.Mortality results from the MAPHY study[J].JAMA,1988,259(13):1976-1982.
• [18]No authors listed.Medical Research Council trial of treatment of hypertension in older adults:principal results.MRC Working Party[J].BMJ,1992,304(6824):405-412.
• [19]No authors listed.Cardiovascular risk and risk factors in a randomized trial of treatment based on the beta-blocker oxprenolol:the International Prospective Primary Prevention Study in Hypertension(IPPPSH).The IPPPSH Collaborative Group[J].J Hypertens,1985,3(4):379-392.
• [20]Dahlof B,Lindholm LH,Hansson L,et al.Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension(STOP-Hypertension)[J].Lancet,1991,338(8778):1281-1285.
• [21]Black HR.,Elliott WJ,Grandits G,et al.Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points(CONVINCE)trial[J].JAMA,2003,289(16):2073-2082.
• [22]Law MR,Morris JK,Wald NJ.Use of blood pressure lowering drugs in the prevention of cardiovascular disease:meta-analysis of147randomised trials in the context of expectations from prospective epidemiological studies[J].BMJ,2009,338:b1665.
• [23]Dahl f B,Devereux RB,Kjeldsen SE,et al.Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study(LIFE):a randomised trial against atenolol[J].Lancet,2002,359(9311):995-1003.
• [24]Dahl f B,Sever PS,Poulter NR,et al.Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required,in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm(ASCOT-BPLA):a multicentre randomised controlled trial[J].Lancet,2005,366(9489):895-906.
• [25]Ding FH,Li Y,Li LH,et al.Impact of heart rate on central he-modynamics and stroke:a meta-analysis ofβ-blocker trials[J].Am J Hypertens,2013,26(1):118-125.
• [26]No authors listed.Tight blood pressure control and risk of macrovascular and microvascular complications in type2diabetes:UKPDS38.UK Prospective Diabetes Study Group[J].BMJ,1998,317(7160):703-713.
• [27]Hansson L,Hedner T,Lund-Johansen P,et al.Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension:The Nordic Diltiazem(NORDIL)study[J].Lancet,2000,356(9227):359-365.
• [28]Zanchetti A,Bond MG,Hennig M,et al.Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis:principal results of the European Lacidipine Study on Atherosclerosis(ELSA),a randomized,double-blind,long-term trial[J].Circulation,2002,106(19):2422-2427.
• [29]Pepine CJ,Handberg EM,Cooper-DeHoff RM,et al.A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease.The International Verapamil-Trandolapril Study(INVEST):a randomized controlled trial[J].JAMA,2003,290(21):2805-2816.
• [30]Wiysonge CS,Bradley HA,Volmink J,et al.Beta-blockers for hypertension[J].Cochrane Database Syst Rev,2012,8:CD002003.
• [31]Chrysant SG,Chrysant GS.Current status ofβ-blockers for the treatment of hypertension:an update[J].Drugs of Today,2012,48(5):353-366.
• [32]Shah NK,Smith SM,Nichols WW,et al.Carvedilol reduces aortic wave reflection and improves leftventricular/vascular coupling:a comparison with atenolol(CENTRAL Study)[J].J Clin Hypertens,2011,13(12):917-924.
• [33]Kampus P,Serg M,Kals J,et al.Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness[J].Hypertension,2011,57(6):1122-1128.
• [34]Khan N,McAlister FA.Re-examining the efficacy of beta-blockers for the treatment of hypertension:a meta-analysis[J].CMAJ,2006,174(12):1737-1742.
• [35]Bakris G,Fonseca V,Katholi RE,et al.Metabolic effects of carvedilol vs metoprolol in patients with type2diabetes mellitus and hypertension:a randomized controlled trial[J].JAMA,2004,292(18):2227-2236.
• [36]Weiss RJ,Saunders E,Greathouse M.Efficacy and toler-ability of nebivolol in stageⅠ-Ⅱhypertension:a pooled analysis of data from three randomized,placebo-controlled monotherapy trials[J].Clin Ther,2011,33(9):1150-1161.
• [37]Tomlinson B,Dalal JJ,Huang J,et al.The role ofβ-blockers in the management of hypertension:an Asian perspective[J].Curr Med Res Opin,2011,27(5):1021-1033.
• [38]López-Sendón J,Swedberg K,McMurray J,et al.Expert consensus document on beta-adrenergic receptor blockers[J].Eur Heart J,2004,25(15):1341-1362.
• [39]Nozawa T,Taguchi M,Tahara K,et al.Influence of CYP2D6genotype on metoprolol plasma concentration and beta-adrenergic inhibition during longterm treatment:a comparison with bisoprolol[J].J Cardiovasc Pharmacol,2005,46(5):713-720.
• [40]Kirchheiner J,Heesch C,Bauer S,et al.Impact of the ultrarapid metabolizer genotype of cytochrome P4502D6on metoprolol pharmacokinetics and pharmacodynamics[J].Clin Pharmacol Ther,2004,76(4):302-312.
• [41]Rau T,Wuttke H,Michels LM,et al.Impact of the CYP2D6genotype on the clinical effects of metoprolol:a prospective longitudinal study[J].Clin Pharmacol Ther,2009,85(3):269-272.
• [42]Carcia-Barcelo M,Chow LY,Chiu HF,et al.Genetic analysis of the CYP2D6locus in Hongkong Chinese populations[J].Clin Chem,2000,46(18):18-23.
• [43]Sehrt D,Meineke I,Tzvetkov M,et al.Carvedilol pharmaco-kinetics and pharmacodynamics in relation to CYP2D6and ADRB pharmacogenetics[J].Pharmacogenomics,2011,12(6):783-795.
• [44]Kamp O,Metra M,Bugatti S,et al.Nebivolol haemodynamic effects and clinical significance of combined beta-blockade and nitric oxide release[J].Drugs,2010,70(1):41-56.
• [45]Paul L,Hastie CE,Li WS,et al.Resting heart rate pattern during follow-up and mortality in hypertensive patients[J].Hypertension,2010,55(2):567-574.
• [46]Okin PM,Kjeldsen SE,Julius S,et al.Effect of changing heart rate during treatment of hypertension on incidence of heart failure[J].Am J Cardiol,2012,109(5):699-704.
• [47]Julius S,Palatini P,Kjeldsen SE,et al.Usefulness of heart rate to predict cardiac events in treated patients with high-risk systemic hypertension[J].Am J Cardiol,2012,109(5):685-692.
• [48]Salles GF,Cardoso CR,Fonseca LL,et al.Prognostic signifi-cance of baseline heart rate and its interaction with beta-blocker use in resistant hypertension:a cohort study[J].Am J Hypertens,2013,26(2):218-226.
• [49]Campbell NR,Khan NA,Hill MD,et al.2009Canadian Hypertension Education Program recommendations:the scientific summary--an annual update[J].Can J Cardiol,2009,25(5):271-277.
• [50]Bangalore S,Steg G,Deedwania P,et al.β-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease[J].JAMA,2012,308(13):1340-1349.
• [51]Gottlieb SS,McCarter RJ,Vogel RA.Effect of betablockade on mortality among high-risk and low-risk patients after myocardial infarction[J].N Engl J Med,1998,339(8):489-497.
• [52]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高急性冠状动脉综合征诊断与治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
• [53]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-690.
• [54]Fihn SD,Gardin JM,Abrams J,et al.2012ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines,and the American College of Physicians,American Association for Thoracic Surgery,Preventive Cardiovascular Nurses Association,Society for Cardiovascular Angiography and Interventions,and Society of Thoracic Surgeons[J].J Am Coll Cardiol,2012,60(24):e44-e164.
• [55]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
• [56]佚名.射血分数正常心力衰竭诊治的中国专家共识[J].中国医刊,2010,45(11):63-67.
• [57]Hernandez AF,Hammill BG,O'Connor CM,et al.Clinical effectiveness of beta-blockers in heart failure:findings from the OPTIMIZE-HF(Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure)Registry[J].J Am Coll Cardiol,2009,53(2):184-192.
• [58]Huang D,Cheng JW.Pharmacologic management of heart failure with preserved ejection fraction[J].Ann Pharmacother,2010,44(12):1933-1945.
• [59]McMurray JJ,Adamopoulos S,Anker SD,et al.ESC guidelines for the diagnosis and treatment of acute and chronic heart failure2012:The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure2012of the European Society of Cardiology.Developed in collaboration with the Heart Failure Association(HFA)of the ESC[J].Eur J Heart Fail,2012,14(8):803-869.
• [60]No authors listed.Effect of metoprolol CR/XL in chronic heart failure:Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure(MERIT-HF)[J].Lancet,1999,353(9169):2001-2007.
• [61]No authors listed.The Cardiac Insufficiency Bisoprolol StudyⅡ(CIBIS-II):a randomised trial[J].Lancet,1999,353(9146):9-13.
• [62]Packer M,Coats AJ,Fowler MB,et al.Effect of carvedilol on survival in severe chronic heart failure[J].N Engl J Med,2001,344(22):1651-1658.
• [63]Waagstein F,Bristow MR,Swedberg K,et al.Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy.Metoprolol in Dilated Cardiomyopathy(MDC)Trial Study Group[J].Lancet,1993,342(8885):1441-1446.
• [64]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1098.
• [65]Toblli JE,DiGennaro F,Giani JF,et al.Nebivolol:impact on cardiac and endothelial function and clinical utility[J].Vasc Health Risk Manag,2012,8:151-160.
• [66]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.β肾上腺素能受体阻滞剂在心血管疾病应用专家共识[J].中华心血管病杂志,2009,37(3):195-209.