抗性高血压:日常实践中的挑战
Katarzyna Stolarz-Skrzypek1, Danuta Czarnecka2
1First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland. katarzyna.stolarz-skrzypek@uj.edu.pl
Polish archives of internal medicine
|December 13, 2023
概括
抗性高血压,定义为尽管服用最佳药物,但血压不受控制,影响有并发症的老年患者. 管理包括评估坚持,排除次要原因,并考虑先进疗法,如螺旋或基于设备的治疗.
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:
- 耐性高血压被定义为血压 (BP) 保持在140/90 mm Hg以上,尽管使用了三种抗高血压药物,包括利尿剂,最大剂量.
- 耐性高血压患者通常比一般高血压患者更老,并患有更多的并发症.
- 确认失控的高血压需要在办公室外测量血压,最好是24小时的门诊血压监测.
研究的目的:
- 概述抗性高血压的定义和诊断考虑因素.
- 强调优化药物治疗的重要性,并排除促成因素.
- 讨论抗性高血压的先进治疗策略.
主要方法:
- 根据血压值和药物治疗方案,对抗性高血压的定义进行审查.
- 强调需要通过门诊监测来确认不受控制的血压.
- 强调排除二次高血压和药物不服药.
- 讨论矿物质皮质类受体抗剂和基于设备的疗法的作用.
主要成果:
- 抗性高血压的特点是年龄较大和伴随性疾病负担较高.
- 伪抗性可能源于不遵守药物或生活方式建议.
- 最佳的药物治疗评估和排除药物相互作用至关重要.
- 建议使用矿物甲类皮质体受体对抗剂 (例如,螺旋) 来扩大治疗的范围,超出三种药物.
- 基于设备的治疗方法是某些患者的选择.
结论:
- 准确诊断耐药高血压需要仔细评估药物坚持,生活方式因素,并排除二次原因.
- 优化现有疗法和考虑矿物质皮质醇受体对抗剂是关键的管理步骤.
- 基于设备的疗法为某些耐药高血压患者提供了额外的选择.
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