Division of Nephrology, Medical University of South Carolina, 96 Jonathan Lucas Street CSB 829, Charleston, SC, 29425, USA,
Curr Hypertens Rep. 2013 Oct;15(5):458-69. doi: 10.1007/s11906-013-0381-0.
Post-transplant hypertension is associated with decreased graft and patient survival and cardiovascular morbidity. Unfortunately, post-transplant hypertension is often poorly controlled. Important risk factors include immunosuppressive medications, complications of the transplant surgery, delayed graft function, rejection, and donor and recipient risk factors. The effects of immunosuppressive medications are multifactorial including increased vascular and sympathetic tone and salt and fluid retention. The immunosuppressive agents most commonly associated with hypertension are glucocorticoids and calcineurin inhibitors. Drug therapy for hypertension should be based on the comorbidities and pathophysiology. Evidence-based approaches to defining and treating hypertension in renal transplant recipients are predominantly extrapolated from large-scale studies performed in the general population. Thus, there continues to be a need for larger studies examining the pathophysiology, diagnosis and treatment of hypertension in renal transplant recipients.
移植后高血压与移植物和患者存活率降低以及心血管发病率有关。不幸的是，移植后高血压常常控制不佳。重要的危险因素包括免疫抑制药物、移植手术并发症、移植物功能延迟、排斥反应以及供体和受体危险因素。免疫抑制药物的作用是多因素的，包括血管和交感神经张力增加以及盐和液体潴留。最常与高血压相关的免疫抑制剂是糖皮质激素和钙调神经磷酸酶抑制剂。高血压的药物治疗应基于合并症和病理生理学。肾移植受者中定义和治疗高血压的循证方法主要是从一般人群中的大规模研究中推断出来的。因此，仍然需要更大规模的研究来研究肾移植受者高血压的病理生理学、诊断和治疗。
