Hatipoglu Emine, Ferro Albert
Department of Clinical Pharmacology, Guy's and St Thomas NHS Foundation Trust , London , UK.
JRSM Cardiovasc Dis. 2013 May 15;2:2048004013486634. doi: 10.1177/2048004013486634.
Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.
高血压是一种常见疾病,伴有重要的心血管并发症。尽管联合使用了肾素-血管紧张素系统阻滞剂、钙通道阻滞剂和最高耐受剂量的利尿剂,但持续血压达到140/90或更高则构成顽固性高血压。除了导致代谢问题(尤其是糖尿病)的发生外,交感神经活动过度在顽固性高血压中起着重要的致病作用。几项研究表明,通过经皮导管基于肾动脉的射频消融来降低肾交感神经活动,可降低顽固性高血压患者的血压,重要的是,该方法基本没有严重并发症。然而,需要更长时间的随访来确认长期安全性和疗效。