治疗耐药高血压患者的交感性缩 (The Symplicity HTN-2试验):一个随机对照试验
1Baker IDI Heart and Diabetes Institute, PO Box 6492, St Kilda Road, Central Melbourne, VIC 8008, Australia. murray.esler@bakeridi.edu.au
Lancet (London, England)
|November 25, 2010
概括
在治疗耐药高血压的患者中,以导管为基础的脏脱膜显著降低血压. 这种安全的程序为管理难以治疗的高血压提供了新的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗器械 医疗器械
背景情况:
- 同情神经的激活是基本高血压的关键因素.
- 耐治疗高血压需要新的治疗策略.
研究的目的:
- 评估以导管为基础的脏脱皮的有效性和安全性.
- 降低治疗耐药高血压患者的血压.
主要方法:
- 进行了一项多中心,前性,随机试验.
- 尽管服用了药物,但患有失控高血压的患者被随机分配到脏缩或继续医疗治疗.
- 主要终点是6个月后静缩血压的变化.
主要成果:
- 脏缺血使缩血压降低了32/12 mm Hg,而对照组的血压降低了1/0 mm Hg.
- 经过脏皮化治疗的84%的患者实现了缩血压降低≥10 mm Hg,而对照组的患者为35%.
- 没有观察到与手术或设备相关的严重并发症.
结论:
- 基于导管的脏皮化是一种安全有效的方法,可以大幅降低血压.
- 这种程序为耐药高血压患者提供了有前途的治疗方法.
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...

