对抗性高血压的管理
Lucas Lauder1, Felix Mahfoud1, Michael Böhm1
1Department of Internal Medicine III, Cardiology, Angiology, and Intensive Care Medicine, Universitätsklinikum des Saarlandes and Saarland University, Homburg, Germany; email: Lucas.Lauder@uks.eu, Felix.Mahfoud@uks.eu, Michael.Boehm@uks.eu.
Annual review of medicine
|September 22, 2023
概括
抗性高血压 (RH) 管理包括改变生活方式和药物治疗. 新兴的干预疗法,如脏缩,为这种严重的疾病提供了新的选择.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 内部医学 内部医学
背景情况:
- 抗性高血压 (RH) 是一种严重的疾病,与心血管风险增加有关.
- 尽管影响不到10%的患者,但RH的患病率很大,并且在不断增长.
- 适当的RH管理需要排除二次原因和伪抗性,如非粘附性和白衣高血压.
研究的目的:
- 审查治疗耐药高血压的理由和最近的临床证据.
- 根据当前的数据,提出一种针对抗性高血压的更新管理算法.
- 突出新兴的干预疗法,包括损伤,作为辅助治疗.
主要方法:
- 对抗性高血压的临床证据和治疗策略的文献综述.
- 对药理学和生活方式修改方法的分析.
- 评估干预技术,特别是以导管为基础的脏皮化.
主要成果:
- 目前的RH治疗包括改变生活方式 (饮食,减肥,运动,限制饮酒) 和药物治疗 (利尿药,MRA,β-阻断剂,ARNI).
- 在过去的15年里,干预方法,特别是脏皮化,作为辅助疗法获得了吸引力.
- 该审查综合了支持更新临床算法的证据.
结论:
- 抗性高血压需要综合管理策略,结合生活方式,药物治疗和潜在的干预程序.
- 脏缩对于精选的RH患者来说是一个有前途的干预选择.
- 一个更新的基于证据的算法可以指导临床医生优化RH治疗并降低心血管风险.
更多相关视频
相关概念视频
Hypertension IV: Drug Therapy and Lifestyle Modifications
12
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...
12
Hypertension V: Nursing Management
11
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.
11
Heart Failure V: Medical Management
12
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...
12
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
454
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...
454
Hypertension and Regulation of Blood Pressure
2.1K
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...
2.1K
Hypertension I: Introduction
16
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
16


