心血管疾病是全球死亡的主要原因,高血压正在成为其发展的独立危险因素。高血压的全球患病率徘徊在30%左右,涵盖了惊人的12亿患者,并每年继续升级。药物在控制高血压中起着关键作用,不仅有效地调节血压,而且大大减轻心脑血管疾病的发生。这篇综述全面概述了类别,机制,临床应用,和传统降压药的缺点。它深入研究了五种主要的药理学分类,即β受体阻滞剂,钙通道阻滞剂(CCB),血管紧张素转换酶抑制剂(ACEI),血管紧张素受体阻滞剂(ARB),和利尿剂。重点放在阐明机制上,优势,以及针对新兴领域的新型降压药物的研究进展。这些包括盐皮质激素受体拮抗剂(MRA),心房利钠肽(ANPs),中性内肽酶抑制剂(NEPIs),钠依赖性葡萄糖转运蛋白2抑制剂(SGLT-2Is),胰高血糖素样肽-1受体激动剂(GLP-1RAs),内皮素受体拮抗剂(ERA),可溶性鸟苷酸环化酶(sGC)激动剂,脑氨基肽酶A抑制剂(APAI),和靶向肝血管紧张素原的小干扰核糖核酸(siRNA)。与常规降压药相比,这些新的替代药物具有良好的抗高血压作用,不良反应最小。本综述为今后抗高血压药物的研究和临床应用提供了有价值的参考。
Cardiovascular disease stands as the leading cause of death globally, with hypertension emerging as an independent risk factor for its development. The worldwide prevalence of hypertension hovers around 30%, encompassing a staggering 1.2 billion patients, and continues to escalate annually. Medication plays a pivotal role in managing hypertension, not only effectively regulating blood pressure (BP) but also substantially mitigating the occurrence of cardiovascular and cerebrovascular diseases. This review comprehensively outlines the categories, mechanisms, clinical applications, and drawbacks of conventional antihypertensive drugs. It delves into the five primary pharmacological classifications, namely β-receptor blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and diuretics. The emphasis is placed on elucidating the mechanisms, advantages, and research progress of novel antihypertensive drugs targeting emerging areas. These include mineralocorticoid receptor antagonists (MRAs), atrial natriuretic peptides (ANPs), neutral endopeptidase inhibitors (NEPIs), sodium-dependent glucose transporter 2 inhibitors (SGLT-2Is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), endothelin receptor antagonists (ERAs), soluble guanylate cyclase (sGC) agonists, brain aminopeptidase A inhibitors (APAIs), and small interfering ribonucleic acids (siRNAs) targeting hepatic angiotensinogen. Compared to conventional antihypertensive drugs, these novel alternatives exhibit favorable antihypertensive effects with minimal adverse reactions. This review serves as a valuable reference for future research and the clinical application of antihypertensive drugs.