Management of Resistant Hypertension.

IF 15.1 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-09-22 DOI:10.1146/annurev-med-050922-052605
Lucas Lauder, Felix Mahfoud, Michael Böhm
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Abstract

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.

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顽固性高血压的管理。
抵抗性高血压(RH)是一种严重的高血压,与心血管风险增加有关。尽管真正的RH影响了不到10%的接受降压治疗的患者,但绝对数字很高,而且还在继续增加。这些患者的检查需要筛查继发性高血压和伪耐药性,包括对处方药的依从性差和白大褂现象。RH的治疗包括生活方式的改变和药物治疗。生活方式的改变包括饮食调整、减肥、体育活动和限制饮酒;药物治疗包括利尿剂、盐皮质激素受体拮抗剂、β受体阻滞剂、血管紧张素受体奈普赖氨酸抑制剂等。在过去的15年里,介入方法已经成为辅助治疗的选择;我们强调基于导管的肾去神经支配。这篇综述总结了基本原理和最新的临床证据,并在此基础上提出了RH管理的更新算法。《医学年度评论》第75卷预计最终在线出版日期为2024年1月。请参阅http://www.annualreviews.org/page/journal/pubdates用于修订估算。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annual review of medicine
Annual review of medicine 医学-医学:内科
CiteScore
24.90
自引率
0.00%
发文量
58
期刊介绍: The Annual Review of Medicine, which has been published since 1950, focuses on important advancements in diverse areas of medicine. These include AIDS/HIV, cardiology, clinical pharmacology, dermatology, endocrinology/metabolism, gastroenterology, genetics, immunology, infectious disease, neurology, oncology/hematology, pediatrics, psychiatry, pulmonology, reproductive medicine, and surgery. The journal's current volume has transitioned from a gated access model to an open access model through the Annual Reviews' Subscribe to Open program. All articles published in the journal are now available under a CC BY license.
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