Treatment-resistant hypertension

Maja Milošević; Petar Otašević

doi:10.5937/arhfarm72-34248

Maja Milošević Univerzitet u Beogradu - Insititut za kardiovaskularne bolesti
Petar Otašević Univerzitet u Beogradu - Medicinski fakultet; Institut za kardovaskularne bolesti Dedinje

DOI: https://doi.org/10.5937/arhfarm72-34248

Ključne reči: stvarna rezistentna hipertenzija, pseudo-rezistentna hipertenzija, sekundarna hipertenzija

Sažetak

Rezistentna hipertenzija je jedan od najznačajnijih uzroka loše regulacije krvnog pritiska. Pacijenti sa rezistentnom hipertenzijom imaju veći rizik od razvoja komorbiditeta u poređenju sa opštom hipertenzivnom populacijom. Kao rezultat toga, ovi pacijenti imaju veću učestalost invalidnosti i prerane smrti, kao i povećane troškove lečenja. Zbog svega navedenog, u prošloj deceniji došlo je do porasta interesovanja istraživača za proučavanje patogeneze, dijagnoze i lečenja rezistentne hipertenzije. Međutim, najnoviji podaci ukazuju da 20% žena i 24% muškaraca sa arterijskom hipertenzijom i dalje ima lošu regulaciju krvnog pritiska, uprkos maksimalnim dozama tri antihipertenzivna leka (uključujući diuretik) i odgovarajućem stilu života. Novi modaliteti lečenja (renalna kateterska denervacija i stimulacija baroreceptora) pružaju nadu za postizanje adekvatne regulacije krvnog pritiska kod ovih pacijenata. U ovom radu sumirali smo dosadašnja saznanja o mehanizmima koji su u osnovi patogeneze rezistentne hipertenzije, kao i optimalnim dijagnostičkim metodama za diferenciranje prave od pseudo-rezistentne hipertenzije. Takođe smo dali pregled aktuelnih terapijskih pristupa, uključujući optimalnu medikamentnu terapiju i nove modalitete lečenja, kao i njihove uloge u lečenju rezistentne hipertenzije.

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