重新审视顽固性高血压
Rethinking Resistant Hypertension.
作者信息
Bourque Gabrielle, Hiremath Swapnil
机构信息
Department of Medicine, University of Ottawa, Ottawa, ON K1H 7W9, Canada.
出版信息
J Clin Med. 2022 Mar 7;11(5):1455. doi: 10.3390/jcm11051455.
Resistant hypertension is common and known to be a risk factor for cardiovascular events, including stroke, myocardial infarction, heart failure, and cardiovascular mortality, as well as adverse renal events, including chronic kidney disease and end-stage kidney disease. This review will discuss the definition of resistant hypertension as well as the most recent evidence regarding its diagnosis, evaluation, and management. The issue of medication non-adherence and its association with apparent treatment-resistant hypertension will be addressed. Non-pharmacological interventions for the treatment of resistant hypertension will be reviewed. Particular emphasis will be placed on pharmacological interventions, highlighting the role of mineralocorticoid receptor antagonists and sodium-glucose cotransporter-2 inhibitors and device therapy, including renal denervation, baroreceptor activation or modulation, and central arteriovenous fistula creation.
难治性高血压很常见，并且已知是心血管事件的危险因素，包括中风、心肌梗死、心力衰竭和心血管死亡，以及不良肾脏事件，包括慢性肾脏病和终末期肾病。本综述将讨论难治性高血压的定义以及有关其诊断、评估和管理的最新证据。将探讨药物治疗依从性问题及其与明显治疗抵抗性高血压的关联。将回顾难治性高血压治疗的非药物干预措施。将特别强调药物干预，突出盐皮质激素受体拮抗剂和钠-葡萄糖协同转运蛋白2抑制剂的作用以及器械治疗，包括肾去神经支配、压力感受器激活或调节以及建立中心动静脉瘘。
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