难治性高血压诊治对策

Resistant hypertension and its evaluation and treatment

难治性高血压是一种特殊类型的高血压,若不及时诊治常导致较严重的靶器官损伤和高发心血管风险。对难治性高血压的评估首先应排除假性治疗抵抗,并充分考虑伴随情况与并发症,尽可能明确导致难治性高血压的原因,包括继发因素。难治性高血压的治疗应首先去除所有导致血压升高的可逆性因素,选择降压药物时力求阻断所有可能导致血压升高的机制。近期一些新的药物和介入治疗措施被证实能够有效治疗难治性高血压。

Summary： Resistant hypertension is a special type of hypertension, often accompanied by more severe target organ damage and high cardiovascular risk if no early diagnosis and treatment. The evaluation resistant hypertension should be directed to- ward confirming true treatment resistance and identification of causes contributing to treatment resistance. After exclusion of factors associated with pseudo-resistance and modification of factors related to true blood pressure elevations, an aggressive treatment regimen designed to compensate for all mechanisms of blood pressure elevation, which will help in moving toward effective blood pressure control for the majority of patients. Recently, several novel drugs and interventional treatments show promise for resistant hypertension.