新的高血压药物,程序和设备
Stéphane Laurent1, Markus Schlaich, Murray Esler
1Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Paris, France. stephane.laurent@egp.aphp.fr
Lancet (London, England)
|August 14, 2012
概括
治疗抗性高血压仍然具有挑战性. 新型药物和创新设备,如巴罗受体刺激和脏缩,提供新的治疗途径,但需要严格的临床评估.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗器械 医疗器械
背景情况:
- 抗性高血压对有效的血压管理构成重大挑战.
- 现有的抗高血压药物和生活方式干预措施都有局限性.
- 对于难以治疗的高血压患者,需要新的治疗策略.
研究的目的:
- 探索对抗性高血压有希望的治疗替代方案.
- 审查新的药理学药剂和创新的程序/基于设备的疗法.
- 讨论治疗策略和临床试验的未来方向.
主要方法:
- 对新型药理学类 (例如,血管酶抑制剂,阿尔多合成酶抑制剂) 和新分子的审查.
- 讨论新的程序和设备 (例如,动脉气质受体刺激,以导管为基础的脏缩).
- 分析临床开发的挑战和需要基于证据的指导方针.
主要成果:
- 几种新的药理学标显示出临床前的前景,但临床翻译是具有挑战性的.
- 新的设备和程序为抗性高血压提供了潜在的替代方案.
- 新型抗高血压药物的临床开发效果不如预期.
结论:
- 新型药物和设备代表了对抗性高血压管理的有希望的途径.
- 仔细评估新干预措施的有效性和安全性至关重要.
- 未来的研究应该专注于结果试验和耐药高血压的基于证据的指导方针.
相关概念视频
Hypertension IV: Drug Therapy and Lifestyle Modifications
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
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 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...
Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Antihypertensive Drugs: Vasodilators
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
