Эволюция подходов к лечению гипертонической болезни

In the early 20 th century hypertension became a medical problem because of th prevalence. The process of clinical research of the etiopathogenesis of hypertension is associated with a scientific and technical progress and state of medical science at every historical stage. The first stage (end of the 19 th century — beginning of the 20 h century) was characterised by a research of hypertension and monitoring of its natural history. The second stage (early — mid 20 th century) was charachterised by attempts to influence on the natural history of hypertension. The basis of the attempts was neurohumoral concept. The third stage (end of 50s — beginning of 70s) — was charachterised by the application of angiotensin -converting enzyme inhibitor, calcium channel blocker and thiazide diuretic along with beta-adrenergic blockers. The fourth stage (end of 20 th century — beginning of 21 st) was characterised by discovery of the renin-angiotensin-aldosterone system, development of complex treatment options for hypertension, based on stratification of risk factors of cardiovascular complication. Clinical picture of hypertension haven’t changed significally during the last 100 years. Cerebral and cardiac manifestations of hypertension remain dominat in 21 st century as well as in 20 h century. In the beginning of 21 st century such systems as eyes and kidneys are not affected by the hypertension. Hypertension remains the main cause of progression of cardiac muscle and vessel wall structural changes.

hypertension, evolution of clinical picture of hypertension, evolution of treatment options