{"title":"Patients with resistant hypertension.","authors":"Jacques Amar","doi":"10.1097/01.hjh.0000271502.85196.d3","DOIUrl":null,"url":null,"abstract":"<p><p>Hypertension remains uncontrolled in the majority of treated patients, especially those with multiple cardiovascular risk factors. This was demonstrated by a French study that showed that 70% of treated hypertensive patients are not controlled to the target level of 140/90 mmHg. This proportion reached 84% in hypertensive patients with diabetes (target level 130/85 mmHg). What are the reasons for this disappointing situation? Observational studies have shown that only a minority of patients with uncontrolled hypertension receive triple therapy including a diuretic. In this respect, self-measurement of blood pressure should improve the situation by allowing clinicians to base their decision to intensify hypertension treatment on more solid evidence than consultation blood pressure measurements alone. Patient-related factors may also contribute to this situation. Treated patients with uncontrolled hypertension often have multiple risk factors. This is associated with or is a source of poor treatment observance linked to patient psychological factors or a result of the increased consumption of medication. Finally, risk factors themselves may be responsible for problems with blood pressure control as a result of their detrimental effects on large arteries as well as the microvascular network. The early correction of such vascular anomalies is vital for medium and long-term blood pressure control.</p>","PeriodicalId":16074,"journal":{"name":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","volume":"25 1","pages":"S3-6"},"PeriodicalIF":0.0000,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjh.0000271502.85196.d3","citationCount":"13","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of hypertension. Supplement : official journal of the International Society of Hypertension","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/01.hjh.0000271502.85196.d3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 13

Abstract

Hypertension remains uncontrolled in the majority of treated patients, especially those with multiple cardiovascular risk factors. This was demonstrated by a French study that showed that 70% of treated hypertensive patients are not controlled to the target level of 140/90 mmHg. This proportion reached 84% in hypertensive patients with diabetes (target level 130/85 mmHg). What are the reasons for this disappointing situation? Observational studies have shown that only a minority of patients with uncontrolled hypertension receive triple therapy including a diuretic. In this respect, self-measurement of blood pressure should improve the situation by allowing clinicians to base their decision to intensify hypertension treatment on more solid evidence than consultation blood pressure measurements alone. Patient-related factors may also contribute to this situation. Treated patients with uncontrolled hypertension often have multiple risk factors. This is associated with or is a source of poor treatment observance linked to patient psychological factors or a result of the increased consumption of medication. Finally, risk factors themselves may be responsible for problems with blood pressure control as a result of their detrimental effects on large arteries as well as the microvascular network. The early correction of such vascular anomalies is vital for medium and long-term blood pressure control.

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顽固性高血压患者。
在大多数接受治疗的患者中,高血压仍然不受控制,特别是那些有多种心血管危险因素的患者。法国的一项研究证实了这一点,该研究表明70%接受治疗的高血压患者没有控制到140/90 mmHg的目标水平。这一比例在合并糖尿病的高血压患者中达到84%(目标水平为130/85 mmHg)。造成这种令人失望的情况的原因是什么?观察性研究表明,只有少数不受控制的高血压患者接受包括利尿剂在内的三联治疗。在这方面,自我测量血压应该改善这种情况,使临床医生能够根据更可靠的证据来决定加强高血压治疗,而不仅仅是咨询血压测量。患者相关因素也可能导致这种情况。接受治疗的未控制的高血压患者通常有多种危险因素。这与与患者心理因素有关的治疗依从性差或药物消耗量增加有关。最后,风险因素本身可能是造成血压控制问题的原因,因为它们对大动脉和微血管网络有不利影响。早期纠正此类血管异常对中长期血压控制至关重要。
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