Prosser Hamish C G, Azzam Omar, Schlaich Markus P
Dobney Hypertension Centre, Faculty of Health and Medical Sciences, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia.
Dobney Hypertension Centre, Faculty of Health and Medical Sciences, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia; Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia; Department of Nephrology, Royal Perth Hospital, Perth, WA, Australia.
Heart Lung Circ. 2018 Aug;27(8):911-916. doi: 10.1016/j.hlc.2018.02.013. Epub 2018 Mar 1.
Resistant hypertension is commonly defined as office blood pressure above recommended target despite the use of optimal doses of at least three antihypertensive drugs including a diuretic. Australian guidelines recommend combination of blockers of the renin-angiotensin system, either ACE inhibitors or angiotensin receptor blockers, with calcium channel blockers and diuretics as the preferred triple therapy. A substantial proportion of hypertensive patients will require additional pharmacotherapy to achieve or get close to target blood pressure levels. Here we briefly review the evidence currently available to provide guidance on the most appropriate choice for additional antihypertensive pharmacotherapy and touch on interventional approaches that may be considered in some patients.
顽固性高血压通常被定义为尽管使用了包括利尿剂在内的至少三种降压药物的最佳剂量，但诊室血压仍高于推荐目标值。澳大利亚指南推荐将肾素 - 血管紧张素系统阻滞剂（血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂）与钙通道阻滞剂和利尿剂联合使用作为首选的三联疗法。相当一部分高血压患者需要额外的药物治疗来达到或接近目标血压水平。在此，我们简要回顾目前可用的证据，为额外的降压药物治疗的最合适选择提供指导，并探讨一些患者可能考虑的介入方法。
