Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Hypertens Res. 2013 Jun;36(6):485-91. doi: 10.1038/hr.2013.30. Epub 2013 Apr 18.
Cardiovascular (CV) complications such as myocardial infarction, heart failure, stroke and renal failure are related to both the degree and the duration of blood pressure (BP) increase. Resistant hypertension (RH) is associated with a higher risk of CV complications and a higher prevalence of target organ damage (TOD). The relationship between CV disease and TOD can be bidirectional. Elevated BP in RH may cause CV structural and functional alterations, and the development or persistence of left ventricular hypertrophy, aortic stiffness, atherosclerotic plaques, microvascular disease and renal dysfunction, may render hypertension more difficult to control. Specifically, RH is related to several conditions, including obesity, sleep apnea, diabetes, metabolic syndrome and hyperaldosteronism, characterized by an overexpression of humoral and hormonal factors that are involved in the development and maintenance of TOD. Optimal therapeutic strategies, including pharmacological treatment and innovative invasive methodologies, have been shown to achieve adequate BP control and induce the regression of TOD, thereby potentially improving patient prognosis.
心血管（CV）并发症，如心肌梗死、心力衰竭、中风和肾衰竭，与血压（BP）升高的程度和持续时间有关。难治性高血压（RH）与更高的 CV 并发症风险和更高的靶器官损伤（TOD）患病率相关。CV 疾病和 TOD 之间的关系是双向的。RH 中的血压升高可能导致 CV 结构和功能改变，左心室肥厚、主动脉僵硬、动脉粥样硬化斑块、微血管疾病和肾功能障碍的发展或持续存在，可能使高血压更难以控制。具体而言，RH 与多种情况有关，包括肥胖、睡眠呼吸暂停、糖尿病、代谢综合征和醛固酮增多症，其特征是涉及 TOD 发展和维持的体液和激素因子过度表达。已证明最佳治疗策略，包括药物治疗和创新的介入方法，可实现足够的 BP 控制并诱导 TOD 消退，从而可能改善患者预后。
