慢性肾脏病与难治性高血压
Chronic Kidney Disease with Resistant Hypertension
晏婉清 1吴昕悦 1任勇2
作者信息
- 1. 武汉科技大学医学部医学院,湖北武汉 430000;湖北文理学院附属医院襄阳市中心医院心血管内科湖北文理学院心血管病研究所,湖北襄阳 441000
- 2. 湖北文理学院附属医院襄阳市中心医院心血管内科湖北文理学院心血管病研究所,湖北襄阳 441000
- 折叠
摘要
难治性高血压是指同时使用3种抗高血压药,血压仍高于目标水平,或至少需要4种药物才能控制血压的严重高血压类别.在高血压患者中,其患病率为5％～15％,而在慢性肾脏病患者中,患病率是普通人群的2-3倍.但肾功能损害及高钾血症等原因限制了螺内酯等高效抗高血压药的使用,增加了治疗难度,慢性肾脏病一旦诊断难治性高血压,最重要的是根据主要病理生理机制针对性地个体化给药.现从慢性肾脏病中难治性高血压的流行病学、特有的病理生理机制、诊断及其治疗进展等方面进行论述.
Abstract
Resistant hypertension is a category of severe hypertension in which blood pressure remains above target levels with the concurrent use of three antihypertensive medications,or in which at least four medications are required to control blood pressure.Among hypertension patients,its prevalence is 5％～15％,while in patients with chronic kidney disease,the prevalence of resistant hypertension is two to three times higher than that of the general population.Once diagnosed with resistant hypertension,patients with chronic kidney disease need to be treated individually according to the main pathophysiological mechanisms,but renal impairment and hyperkalemia limit the use of highly effective antihypertensive drugs such as spironolactone and increase the difficulty of treatment.Its therapeutic specificity needs to be learned together by clinicians.In this paper,we will review the epidemiology,specific pathophysiological mechanisms,diagnosis and therapeutic advances of resistant hypertension in chronic kidney disease.
关键词
难治性高血压/慢性肾脏病/利尿剂/盐皮质激素受体拮抗剂Key words
Resistant hypertension/Chronic kidney disease/Diuretic/Mineralocorticoid receptor antagonist引用本文复制引用
出版年
2024
NETL
NSTL
万方数据