抗性高血压:诊断,评估和治疗 泰国高血压协会的一份临床共识声明
Pairoj Chattranukulchai1, Weranuj Roubsanthisuk2, Sirisawat Kunanon3
1Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
概括
抗性高血压 (RH),影响大约5%的高血压患者,显著增加心血管风险. 有效的管理包括改变生活方式,调整药物,并考虑用于控制不良血压 (BP) 的装置治疗.
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 (RH) 是通过不控制的血压 (BP) 定义的,尽管多种药物.
- 红血压影响大约5%的高血压患者,并与心血管风险增加有关.
- 准确的诊断需要排除伪抗性,并调查高血压的次要原因.
研究的目的:
- 提供对抗性高血压的诊断和管理的概述.
- 为了强调精确的BP测量和坚持确认的重要性.
- 讨论治疗策略,包括改变生活方式,药物调整和基于设备的疗法.
主要方法:
- 对抗性高血压的诊断标准的审查.
- 强调通过标准化BP测量和坚持检查排除伪电阻.
- 讨论药理干预措施,包括利尿剂的选择和萨库比特里尔/瓦尔萨坦的潜在使用.
- 考虑基于设备的疗法,如对耐火病例的脏缩.
主要成果:
- 抗性高血压的特点是心血管风险高.
- 准确的诊断至关重要,涉及排除伪抗性和次要原因.
- 管理策略包括生活方式干预,优化抗高血压药物治疗方案和潜在的设备治疗.
结论:
- 个性化的患者特征应指导耐药高血压的管理.
- 建议对治疗强化采取逐步的方法.
- 在医疗管理失败后,应该为精心挑选的患者保留基于设备的疗法.
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