交感神经系统在顽固性高血压中的作用:病理生理和临床方面

A. Orekhov, L. Karazhanova
{"title":"交感神经系统在顽固性高血压中的作用:病理生理和临床方面","authors":"A. Orekhov, L. Karazhanova","doi":"10.18705/1607-419x-2022-28-4-348-356","DOIUrl":null,"url":null,"abstract":"Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"53 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The role of the sympathetic nervous system in resistant hypertension: pathophysiological and clinical aspects\",\"authors\":\"A. Orekhov, L. Karazhanova\",\"doi\":\"10.18705/1607-419x-2022-28-4-348-356\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.\",\"PeriodicalId\":37695,\"journal\":{\"name\":\"Arterial Hypertension (Russian Federation)\",\"volume\":\"53 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arterial Hypertension (Russian Federation)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18705/1607-419x-2022-28-4-348-356\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arterial Hypertension (Russian Federation)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18705/1607-419x-2022-28-4-348-356","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

顽固性动脉高血压(HTN)是心血管疾病和死亡的重要危险因素。肥胖、阻塞性睡眠呼吸暂停、高醛固酮增多症等临床情况是这些患者临床表型的相关环节。同时,这些条件是相互关联的病理生理基础,即交感神经系统的活动。目标。将持续交感神经系统过度激活在耐药HTN发生和发展中的作用数据系统化。设计和方法。我们在数据库(PubMed, Cochrane Library)中检索了临床研究和系统综述,研究了交感神经过度驱动的作用,以及旨在阻断交感神经激活的耐药HTN的治疗方法。结果。交感神经系统活动增加是形成抗高血压治疗抵抗的最重要环节之一。此外,慢性交感神经过度驱动结合了抵抗性HTN最常见的危险因素,即阻塞性睡眠呼吸暂停、肥胖和胰岛素抵抗、肾素-血管紧张素系统激活和醛固酮分泌过多。结论。近几十年来,人们对交感神经系统研究的兴趣日益浓厚,这有助于积累耐药HTN的病理生理和临床方面的新数据,并通过将肾动脉交感神经去支配技术引入临床实践,扩大了其治疗方法。对交感神经激活的进一步研究有助于开发新的治疗技术,并将改变对耐药HTN患者的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The role of the sympathetic nervous system in resistant hypertension: pathophysiological and clinical aspects
Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Arterial Hypertension (Russian Federation)
Arterial Hypertension (Russian Federation) Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.90
自引率
0.00%
发文量
38
期刊介绍: The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.
期刊最新文献
The efficacy of antihypertensive therapy according to the results of the CONSONANCE program: is achieving the target blood pressure level the sole criterion? History of the study of arterial hypertension from Cesalpino to the 21<sup>st</sup> century The relationship of epicardial adipose tissue and metabolic syndrome Management of pregnant women with pheochromocytoma: clinical cases and literature review Clinical and laboratory characteristics of COVID-19 in hospitalized hypertensive patients
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1