Phương pháp điều trị thuyết phục cho LVH: những suy luận thẳng (và không thẳng) từ bằng chứng
Tóm tắt
Chúng tôi đã đọc với sự quan tâm hướng dẫn của Hiệp hội Tăng huyết áp Hàn Quốc về việc quản lý bệnh tăng huyết áp và chúc mừng Hiệp hội về việc xem xét tài liệu một cách toàn diện trong quá trình soạn thảo hướng dẫn. Hướng dẫn chỉ ra rằng nên ưu tiên ACE-I và CCB hơn là thuốc lợi tiểu cho bệnh nhân bị phì đại thất trái. Tuy nhiên, trong các thử nghiệm so sánh trực tiếp quan trọng, thuốc lợi tiểu tương tự thiazide chlorthalidone đã được chứng minh là vượt trội hơn ACE-I và CCB trong việc giảm khối lượng thất trái và ngăn ngừa suy tim ở bệnh nhân tăng huyết áp. Hơn nữa, chúng tôi nêu ra phát hiện nghịch lý rằng việc đơn thuần giảm phì đại thất trái không phải lúc nào cũng dẫn đến việc giảm nguy cơ suy tim; và rằng các tác động đa diện của chlorthalidone có thể là lý do giải thích cho hoạt động có lợi của nó trong suy tim.
Từ khóa
Tài liệu tham khảo
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