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[临床实践中继发性高血压的诊断]

[Diagnostic of secondary hypertension in clinical practice].

作者信息

Somlóová Z, Rosa J, Petrák O, Strauch B, Zelinka T, Holaj R, Widimský J

机构信息

III. interní klinika 1. lékarské fakulty UK a VFN Praha.

出版信息

Vnitr Lek. 2011 Sep;57(9):772-6.

Abstract

Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5-10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma, hypercortisolism, hyperparathyreoidism), renal - renovascular and renal parenchymal hypertension, and other causes as sleep apnoe syndrome, hypertension in pregnancy, coarctation of the aorta and intracranial tumors.

摘要

动脉高血压是一种全球常见疾病,患病率约为26%。5%-10%的高血压患者存在继发性病因。对于所有难治性高血压患者、高血压控制突然恶化的患者以及有与继发性高血压相关疾病的实验室和临床体征的患者,我们都应考虑继发性高血压。区分继发性高血压和假性难治性高血压(治疗依从性差、白大衣综合征)很重要。高血压的继发性病因可分为内分泌性(原发性醛固酮增多症、嗜铬细胞瘤、皮质醇增多症、甲状旁腺功能亢进)、肾性——肾血管性和肾实质性高血压,以及其他病因,如睡眠呼吸暂停综合征、妊娠期高血压、主动脉缩窄和颅内肿瘤。

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