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1979年底,我们在美国参观访问期间,曾了解美国对几种心血管疾病诊疗的近况,现簡介如下,供参考。高血压病在美国,高血压病人,一般均门诊诊治,定期到医院复查。继发性高血压病人須住院治疗,以确定病因。许多医院可作血清肾素活动度测定,将病人分为低肾素、高腎素及正常肾素三类。其治疗一般采取下列方案: 1.血压高于正常,应多次复查,須排除继发性高血压,还要长期随访。 2.舒张压>105mmHg,应积极使用药物治疗。 3.舒张压为90～104mmHg,治疗须个别化,应去除誘发因素,进少盐飲食。 4.药物治疗多采用下列“阶梯治疗”。第一级:低肾素高血压者首选利尿剂,正常及高腎素高血压者
At the end of 1979, during our visit to the United States, we learned about the status of the United States in the diagnosis and treatment of several cardiovascular diseases. The briefing is as follows. Hypertension in the United States, hypertensive patients, are generally out-patient diagnosis and treatment, regular review to the hospital. Patients with secondary hypertension should be hospitalized to determine the cause. Many hospitals can be used for determination of serum renin activity, the patient is divided into low renin, high renin and normal renin three categories. The treatment generally take the following programs: 1. Blood pressure is higher than normal, should be repeated, to exclude secondary hypertension, but also long-term follow-up. 2. Diastolic blood pressure> 105mmHg, should be actively used drug treatment. 3. Diastolic blood pressure 90 ~ 104mmHg, treatment should be individualized, should remove the predisposing factors, into the salt diet. 4. Medical treatment and more use of the following “ladder treatment.” The first level: low renin hypertension preferred diuretics, normal and high renin hypertension