对抗性高血压的新潜在治疗方法
Arun Janakiraman1, Debbie L Cohen2
1Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, 1 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA, 19147, USA.
Current cardiology reports
|September 27, 2023
概括
抵抗性高血压 (RH) 的管理是具有挑战性的. 新兴的疗法,如双内末林受体抗剂和阿尔多氨酸合成酶抑制剂,有望在RH患者中改善血压控制.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 耐性高血压 (RH) 被定义为尽管使用了三种抗高血压药物 (包括利尿剂) 或四种或更多种药物,但血压仍然升高.
- 患有RH的患者面临心血管和并发症的风险增加.
- 区分真正的RH和明显的RH至关重要,因为真正的RH需要排除诊断.
研究的目的:
- 审查当前对抗性高血压的治疗策略.
- 突出新兴疗法及其对血压控制的潜在影响.
主要方法:
- 审查当前文学和临床试验数据对抗性高血压治疗.
- 专注于新的药理学药剂和干预程序.
主要成果:
- 诊断出RH的标准治疗包括一种利尿剂,通常是一种矿物质皮质醇.
- 较新的药物,如双内末林受体抗剂和阿尔多氨酸合成酶抑制剂,在试验中显示出有效性.
- 已批准的药物,如SGLT2抑制剂和芬,以及脏缩,是重要的考虑因素.
结论:
- 耐性高血压治疗仍然具有挑战性,往往使血压目标难以实现.
- 新兴疗法为改善RH患者血压管理提供了显著的希望.
- 将新型药物和程序纳入治疗模式对于优化结果至关重要.
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
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
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
191
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
191
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
Antihypertensive Drugs: Direct Renin Inhibitors
667
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
667
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
190
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
190


