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高血压是一种非常复杂的疾病,其收缩压和/或舒张压水平持续升高,显著增加了患主要心血管和肾脏事件的风险。虽然降压治疗减少了高血压相关疾病的负担,但在全球范围内血压控制仍然难以达标,顽固性高血压(或称难治性高血压)是导致这种治疗失败的一个重要因素。“顽固性高血压”的诊断在临床是很普遍的,但它经常被误定义为患者血压难以达标的情况。临床医生不规范地使用这个定义可能会引起不利于血压控制的医疗行为;另一方面,顽固性高血压的正确诊断有利于高血压的有效治疗。本文我们将回顾和讨论顽固性高血压的定义、病理生理学机制、诊断和新的治疗方法。
Hypertension is a very complex disease with a sustained increase in systolic and / or diastolic blood pressure, significantly increasing the risk of major cardiovascular and renal events. Although antihypertensive treatment reduces the burden of hypertension-related diseases, blood pressure control remains difficult to achieve worldwide and refractory hypertension (or refractory hypertension) is an important factor in the failure of this treatment. The diagnosis of intractable hypertension is clinically common, but it is often misinterpreted as a condition in which patients’ blood pressure is difficult to achieve. Undefined use of this definition by clinicians may lead to medical behaviors that are detrimental to blood pressure control; on the other hand, the correct diagnosis of refractory hypertension is beneficial for the effective treatment of hypertension. In this article we will review and discuss the definition of refractory hypertension, pathophysiology, diagnosis and new treatments.