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管理并存难治性高血压和射血分数降低的心力衰竭患者高血压的当代策略

Contemporary Strategies to Manage High Blood Pressure in Patients with Coexistent Resistant Hypertension and Heart Failure With Reduced Ejection Fraction.

作者信息

Lang Katherine, Van Iterson Erik H, Laffin Luke J

机构信息

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Section of Preventive Cardiology and Rehabilitation, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Cardiol Ther. 2021 Jun;10(1):9-25. doi: 10.1007/s40119-020-00203-5. Epub 2020 Nov 17.

Abstract

Resistant hypertension (RH) represents an advanced subtype of hypertension that is complex to diagnose and treat. Compared with general hypertension, RH increases the risk patients will develop more advanced cardiovascular complications, including heart failure with reduced ejection fraction (HFrEF). As expected, the prevalence of RH has increased since the introduction of lower blood pressure targets included in the recent 2017 American blood pressure guidelines. The array of pharmacotherapies available to treat both hypertension and HFrEF has also expanded within the past decade. However, the efficacy of these cutting-edge pharmacotherapies has not come without a more advanced understanding of the important adjunct role non-pharmacological therapies play in helping with the management of both hypertension and HFrEF. In this review, we provide a summary of the latest pharmacological and non-pharmacological strategies that can be used to initiate treatment and optimize long-term blood pressure control in patients with coexistent RH and HFrEF.

摘要

顽固性高血压(RH)是高血压的一种晚期亚型,诊断和治疗都很复杂。与一般高血压相比,RH会增加患者发生更严重心血管并发症的风险,包括射血分数降低的心力衰竭(HFrEF)。不出所料,自2017年美国最新血压指南引入更低血压目标以来,RH的患病率有所上升。在过去十年中,可用于治疗高血压和HFrEF的药物疗法种类也有所增加。然而,要更有效地发挥这些前沿药物疗法的功效,就需要更深入地了解非药物疗法在辅助管理高血压和HFrEF方面的重要作用。在本综述中,我们总结了可用于启动治疗并优化合并RH和HFrEF患者长期血压控制的最新药物和非药物策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66cd/8126536/acbd31aab95a/40119_2020_203_Fig1_HTML.jpg

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