心脏移植患者高血压的管理:一个持续的难题
Juan Duarte Torres1, Selim R Krim2,3
1Hospital Central De La Defensa Gomez Ulla, Madrid, Spain.
Current opinion in cardiology
|March 28, 2024
概括
心脏移植后高血压是常见的. 通道阻塞剂,ACE抑制剂和ARBs是管理血压和预防并发症的首选药物,SGLT2抑制剂显示出有前途.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植 移植 移植 移植
背景情况:
- 高血压是心脏移植后的常见并发症.
- 有效的血压管理对于预防诸如左心室重塑,扩张功能障碍和中风等不良结果至关重要.
研究的目的:
- 在心脏移植后阶段审查高血压的病理生理学.
- 为心脏移植接受者提供当前抗高血压疗法的最新信息.
主要方法:
- 对心脏移植后高血压的病理生理学和治疗选择的文献综述.
- 对各种抗高血压药物类别的当前证据的分析.
主要成果:
- 通道阻断剂 (CCB) 是首选的早期移植后,可能提供保护.
- ангиотензин转化酶抑制剂 (ACEI) 和 ангиотензин受体阻断剂 (ARB) 作为二线药物,有助于预防病.
- -葡萄糖共载体2抑制剂 (SGLT2i) 显示出有希望的结果,特别是在糖尿病和慢性病患者中,尽管需要更多的数据. 目前还不建议使用 ангиотензин受体-neprilysin抑制 (ARNI).
结论:
- 心脏移植后的高血压非常普遍.
- 早期降低类固醇和修改危险因素至关重要.
- 建议使用CCB,ACEI和ARB来管理高血压并改善结果. SGLT2 抑制剂可能提供额外的益处,但需要进一步研究.
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