文献詳細
特集 脳神経外科医が知っておくべき生活習慣病の最新治療
Ⅱ 主な生活習慣病の最新治療
文献概要
Point
・高血圧は,脳梗塞,脳出血両者の危険因子である.
・高血圧性脳血管病変は,白質病変,ラクナ梗塞を代表とする脳小血管病に反映される.
・高血圧に対する降圧療法は脳卒中発症,再発予防に有効だが,特に厳格な降圧療法は脳出血予防に有用である.
・高血圧は,脳梗塞,脳出血両者の危険因子である.
・高血圧性脳血管病変は,白質病変,ラクナ梗塞を代表とする脳小血管病に反映される.
・高血圧に対する降圧療法は脳卒中発症,再発予防に有効だが,特に厳格な降圧療法は脳出血予防に有用である.
参考文献
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