Doumas Michael, Tsioufis Costas, Faselis Charles, Lazaridis Antonios, Grassos Haris, Papademetriou Vasilios
Michael Doumas, Antonios Lazaridis, 2 Propedeutic Department of Internal Medicine, Aristotle University, 54643 Thessaloniki, Greece.
World J Cardiol. 2014 Oct 26;6(10):1080-90. doi: 10.4330/wjc.v6.i10.1080.
Hypertension is one of the most popular fields of research in modern medicine due to its high prevalence and its major impact on cardiovascular risk and consequently on global health. Indeed, about one third of individuals worldwide has hypertension and is under increased long-term risk of myocardial infarction, stroke or cardiovascular death. On the other hand, resistant hypertension, the "uncontrollable" part of arterial hypertension despite appropriate therapy, comprises a much greater menace since long-standing, high levels of blood pressure along with concomitant debilitating entities such as chronic kidney disease and diabetes mellitus create a prominent high cardiovascular risk milieu. However, despite the alarming consequences, resistant hypertension and its effective management still have not received proper scientific attention. Aspects like the exact prevalence and prognosis are yet to be clarified. In an effort to manage patients with resistant hypertension appropriately, clinical doctors are still racking their brains in order to find the best therapeutic algorithm and surmount the substantial difficulties in controlling this clinical entity. This review aims to shed light on the effective management of resistant hypertension and provide practical recommendations for clinicians dealing with such patients.
高血压是现代医学中最热门的研究领域之一，因其高患病率以及对心血管风险进而对全球健康的重大影响。事实上，全球约三分之一的人患有高血压，并且长期面临心肌梗死、中风或心血管死亡的风险增加。另一方面，顽固性高血压，即尽管进行了适当治疗但仍“无法控制”的动脉高血压部分，构成了更大的威胁，因为长期的高水平血压以及诸如慢性肾病和糖尿病等伴随的衰弱性疾病会形成显著的高心血管风险环境。然而，尽管后果令人担忧，但顽固性高血压及其有效管理仍未得到应有的科学关注。诸如确切患病率和预后等方面仍有待阐明。为了恰当地管理顽固性高血压患者，临床医生仍在绞尽脑汁，以找到最佳治疗方案并克服控制这一临床病症的巨大困难。本综述旨在阐明顽固性高血压的有效管理，并为处理此类患者的临床医生提供实用建议。
