Small Forum 1999.1.12

Small Forum 1999.1.12

1. Before 1927, it was generally believed that hypertensive patients did not need antihypertensive treatment. In the same year, Smich proposed using adrenergic nerve blockers, leading to the widespread use of reserpine and antihypertensive pills. Later, adrenergic receptor blockers emerged, including α-blockers, β-blockers, calcium channel blockers, and angiotensin-converting enzyme inhibitors.

2. Obstructive sleep apnea syndrome (OSAS) affects 50%–90% of hypertensive patients, with those experiencing more than 20 episodes per night having an 8-year mortality rate of 37%.

3. Some foreign experts believe that nifedipine (Corinfar), due to its short duration of action, cannot cover nighttime and early morning hypertension, causing intermittent blood pressure fluctuations and potentially leading to myocardial ischemia. However, this view is not universally accepted in the medical community. Recently, extended-release nifedipine tablets and amlodipine (Norvasc) have emerged.

4. Recent advances in understanding hypertension have revealed that the central mechanism involves insulin resistance. When hypertension occurs, tissues become less sensitive to insulin's promotion of glucose utilization, leading to hyperinsulinemia, which over time promotes dyslipidemia.