Ben-Dov Iddo Z, Yusuf Amal, Varshitski Boris, Danenberg Haim D
Nephrology Department, Hadassah Medical Center, Jerusalem.
Cardiology Department, Hadassah Medical Center, Jerusalem.
Harefuah. 2021 Apr;160(4):205-209.
Resistant hypertension is a commonplace condition among patients referred to specialty hypertension clinics, which is associated with increased morbidity and mortality. Refractory hypertension however is a rare extreme subtype of resistant hypertension in which blood pressure is uncontrolled despite treatment with five antihypertensive drug classes including a diuretic and a mineralocorticoid receptor antagonist, and is associated with even worse prognosis. We herein describe a 40-year-old woman with severe refractory hypertension and target organ damage for who percutaneous renal sympathetic denervation successfully reduced blood pressure to normal levels and alleviated chronic headaches. Renal denervation should be considered in patients with refractory hypertension, especially when sympathetic over-activity is suspected.
顽固性高血压在转诊至高血压专科诊所的患者中很常见,与发病率和死亡率增加相关。然而,难治性高血压是顽固性高血压中一种罕见的极端亚型,尽管使用了包括利尿剂和盐皮质激素受体拮抗剂在内的五类抗高血压药物进行治疗,血压仍未得到控制,且预后更差。我们在此描述一名40岁患有严重难治性高血压和靶器官损害的女性,经皮肾交感神经去支配术成功将其血压降至正常水平并缓解了慢性头痛。对于难治性高血压患者,尤其是怀疑交感神经过度活跃时,应考虑进行肾去神经支配术。