医学
抵抗性高血压
血管紧张素受体阻滞剂
盐皮质激素受体
重症监护医学
限制
白大衣高血压
内科学
高血容量
血压
醛固酮
肾素-血管紧张素系统
动态血压
血容量
机械工程
工程类
作者
Lucas Lauder,Felix Mahfoud,Michael Böhm
出处
期刊:Annual Review of Medicine
[Annual Reviews]
日期:2023-09-22
卷期号:75 (1)
标识
DOI:10.1146/annurev-med-050922-052605
摘要
Resistant hypertension (RH) is a severe form of hypertension associated with increased cardiovascular risk. Although true RH affects less than 10% of the patients receiving antihypertensive therapy, the absolute number is high and continues to increase. The workup of these patients requires screening for secondary hypertension and pseudoresistance, including poor adherence to prescribed medicines and the white-coat phenomenon. The treatment of RH consists of lifestyle modifications and pharmacological therapies. Lifestyle modifications include dietary adjustments, weight loss, physical activity, and limiting alcohol consumption; pharmacological therapies include diuretics, mineralocorticoid receptor antagonists, beta blockers, angiotensin receptor–neprilysin inhibitors, and others. Over the last 15 years, interventional approaches have emerged as adjunct treatment options; we highlight catheter-based renal denervation. This review summarizes the rationales and latest clinical evidence and, based thereon, proposes an updated algorithm for the management of RH. Expected final online publication date for the Annual Review of Medicine, Volume 75 is January 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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