CONTRIBUTION OF INAPPROPRIATE TREATMENT FOR HYPERTENSION TO PATHOGENESIS OF STROKE IN THE ELDERLY
CONTRIBUTION OF INAPPROPRIATE TREATMENT FOR HYPERTENSION TO PATHOGENESIS OF STROKE IN THE ELDERLY
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DOI：
10.1136/bmj.293.6552.914
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发表时间：
1986-10-11
影响因子：
105.7
通讯作者：
POELS, EFJ
中科院分区：
文献类型：
--
作者：
JANSEN, PAF;GRIBNAU, FWJ;POELS, EFJ
对178例因急性脑梗塞或短暂性脑缺血发作入院的患者进行了研究，以确定他们在过去三周内是否改变了治疗，并将他们中风后的血压与病前值进行比较。100名患者在卒中前一年内进行了血压测量;其中7名患者最近改变了抗高血压或利尿剂治疗。其中，3名患者开始服用速尿，因为高血压和利血平组合药物的剂量已增加1经历了中风后血压明显下降，他们也表现出血液浓缩的迹象。治疗变化可能导致这4例患者发生卒中。其他3例显示血压下降幅度较小甚至升高，且无血液浓缩迹象;这些患者中治疗变化与卒中之间的关系不太可能。在高血压治疗中使用高上限利尿剂（如速尿）可能会引起低血容量和低血压，导致脑缺血，因此在此类治疗中最好避免。
One hundred and seventy eight patients admitted to hospital with acute cerebral infarction or transient ischaemic attack were studied to determine if their treatment has been changed duirng the previous three weeks and to compare their blood pressure after the stroke with premorbid values. Blood pressure measurements taken within one year before the stroke were available for 100 patients; seven of these had had a recent change in antihypertensive or diuretic treatment. Of these, three patients who had started taking frusemide because of hypertension and one whose dosage of a reserpine combination drug had been increased experienced an appreciable decrease in blood pressure immediately after the stroke; they also showed signs of haemoconcentration. The change in treatment probably contributed to the stroke in these four patients. The other three showed a smaller decrease or even an increase in blood pressure and no signs of haemoconcentration; the relation between the change in treatment and stroke is less likely in these patients. The use of high ceiling diuretics such as frusemide in the treatment of hypertension may induce hypovolaemia and hypotension, resulting in cerebral ischaemia, and are therefore best avoided in such treatment.