Spinar J, Vítovec J, Spinarová L
Interni kardiologicka klinika Lekarske fakulty MU a FN Brno.
Vnitr Lek. 2013 Aug;59(8):724-9.
Arterial hypertension is a worldwide serious clinical problem. It affects 30- 40% of the adult population. Resistant hypertension is defined as systolic blood pressure that remains 140mmHg while in the doctors surgery and/ or as average systolic blood pressure during a 24- hour monitoring of an outpatient 130mmHg after a combination of three antihypertensive agents (including a diuretic) has been administered in the maximum tolerated dose amounts. Renal denervation is an invasive method of catheter radio frequency ablation of sympathetic nerves located in the walls of renal arteries. The results of the Symplicity HTN 1 and HTN 2 trials proved that renal denervation can safely decrease blood pressure in patients with resistant hypertension. Further research is necessary in order to verify these data, to clarify the questions which remained unanswered and to evaluate future applications of renal denervation. Current experience and recommendations are included, as well as an overview of existing denervation devices and devices which are in development.
动脉高血压是一个全球性的严重临床问题。它影响着30%至40%的成年人口。顽固性高血压的定义为:在医生诊室时收缩压仍保持在140mmHg,和/或在门诊患者进行24小时监测期间,在联合使用三种抗高血压药物(包括一种利尿剂)并达到最大耐受剂量后,平均收缩压为130mmHg。肾去神经支配是一种通过导管对位于肾动脉壁的交感神经进行射频消融的侵入性方法。Symplicity HTN-1和HTN-2试验的结果证明,肾去神经支配可以安全地降低顽固性高血压患者的血压。为了验证这些数据、澄清尚未解答的问题以及评估肾去神经支配的未来应用,还需要进一步的研究。文中包括了当前的经验和建议,以及现有去神经支配设备和正在研发的设备的概述。