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耐药性高血压的发病机制与治疗进展。

Advances in the Pathogenesis and Treatment of Resistant Hypertension.

机构信息

Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Łódź, Poland.

Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Żeromskiego 113, 90-549 Łódź, Poland.

出版信息

Int J Mol Sci. 2023 Aug 18;24(16):12911. doi: 10.3390/ijms241612911.

Abstract

Hypertension is a prevalent chronic disease associated with an increased risk of cardiovascular (CV) premature death, and its severe form manifests as resistant hypertension (RH). The accurate prevalence of resistant hypertension is difficult to determine due to the discrepancy in data from various populations, but according to recent publications, it ranges from 6% to 18% in hypertensive patients. However, a comprehensive understanding of the pathogenesis and treatment of RH is essential. This review emphasizes the importance of identifying the causes of treatment resistance in antihypertensive therapy and highlights the utilization of appropriate diagnostic methods. We discussed innovative therapies such as autonomic neuromodulation techniques like renal denervation (RDN) and carotid baroreceptor stimulation, along with invasive interventions such as arteriovenous anastomosis as potential approaches to support patients with inadequate medical treatment and enhance outcomes in RH.

摘要

高血压是一种常见的慢性疾病,与心血管(CV)过早死亡的风险增加有关,其严重形式表现为耐药性高血压(RH)。由于来自不同人群的数据差异,耐药性高血压的确切患病率难以确定,但根据最近的出版物,高血压患者中的比例在 6%至 18%之间。然而,全面了解 RH 的发病机制和治疗方法至关重要。本综述强调了在抗高血压治疗中确定治疗抵抗原因的重要性,并强调了适当诊断方法的利用。我们讨论了创新疗法,如自主神经调节技术(如肾去神经支配(RDN)和颈动脉压力感受器刺激)以及侵袭性干预,如动静脉吻合术,作为支持药物治疗不足的患者的潜在方法,并提高 RH 患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c0f/10454510/d4fe5547a5bb/ijms-24-12911-g001.jpg

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