Wallbach M, Koziolek M J
Klinik für Nephrologie und Rheumatologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
Internist (Berl). 2018 Jun;59(6):567-579. doi: 10.1007/s00108-018-0430-5.
Therapy-resistant and therapy-refractory arterial hypertension differ in prevalence, pathogenesis, prognosis and therapy. In both cases, a structured approach is required, with the exclusion of pseudoresistance and, subsequently, secondary hypertension. Resistant hypertension has been reported to be more responsive to intensified diuretic therapy, whereas refractory hypertension is presumed to require sympathoinhibitory therapy. Once the general measures and the drug-based step-up therapy have been exhausted, interventional procedures are available.
难治性和顽固性动脉高血压在患病率、发病机制、预后和治疗方面存在差异。在这两种情况下,都需要一种结构化的方法,排除假性耐药,随后排除继发性高血压。据报道,顽固性高血压对强化利尿治疗反应更好,而顽固性高血压则被认为需要交感神经抑制治疗。一旦常规措施和基于药物的逐步治疗方法用尽,可采用介入治疗手段。