Refractory hypertension: diagnosis and treatment optimization

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Resistant hypertension occurs in up to 15% of patients with arterial hypertension in Russia. Medical treatment of resistant hypertension must include minimum 3 medications with maximum or maximum tolerated doses besides one of the medications must be diuretic. According to department of arterial hypertension of the Burdenko Main Military Clinical Hospital to achieve the target levels of arterial blood pressure it was necessary to prescribe 4-5 components antihypertension therapy in patients. Authors suggested an algorithm of diagnosis and treatment of patients with resistant hypertension with the help of surgical method. This method is based on decreasing of sympathic nervous system activity by selective break of neuronal connections with the help of interventional intravascular radio-wave ablation. Endovascular renal sympathetic denervation allows to effectively control arterial blood pressure, to optimize antihypertensive therapy, but this method does not cure from arterial hypertension.

Full Text

Restricted Access

References

  1. Диагностика и лечение артериальной гипертензии. Российские рекомендации (4-й пересмотр). Москва, 2010 г. // Системные гипертензии. - 2010. - № 3. - С. 5-26.
  2. Рекомендации по лечению артериальной гипертонии Европейского общества по гипертонии (ESH) и Европейского общества кардиологов (ESC) 2013 г. // J. Hypertens. - 2013. - Vol. 31. - P. 1281-1357.
  3. Фурсов А.Н., Потехин Н.П., Чернов С.А. и др. Гипертоническая болезнь: диагностика и дифференциальные подходы к гипотензивной терапии // Воен.-мед. журн. - 2012. - Т. 333, № 11. - С. 45-50.
  4. Фурсов А.Н., Потехин Н.П., Чернов С.А. и др. Гипертоническая болезнь: структура и причина госпитализации // Воен.-мед. журн. - 2012. - Т. 333, № 9. - С. 69-70.
  5. Bakris G.L., Nadim M.K., Haller H. et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of longterm follow-up in the Rheos Pivotal Trial // J. Am. Soc. Hypertens. - 2012. - Vol. 6. -P. 152-158. «(Военно-медицинский журнал», 5’2014_
  6. Daugherty S.L., Powers J.D., Magid D.J. et al. Incidence and prognosis of resistant hypertension in hypertensive patients // Circulation. - 2012. - Vol. 125. - P. 1635-1642.
  7. Laurent S., Schlaich M., Esler M. New drugs procedures and devices for hypertension // Lancet. - 2012. - Vol. 380. - P. 591-600.
  8. Mahfoud F., Luscher T.F., Andersson B. et al. Expert consensus document from the European Society of Cardiology on catheter-based renal denervation // Eur. Heart J. - 2013. - Vol. 10. -P. 1093.
  9. Mahfoud F., Schlaich M., Kindermann I. et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study // Circulation. - 2011. - Vol. 123. - P. 1940-1944.
  10. Schmieder R.E., Redon J., Grassi G. et al. ESH position paper: renal denervation - an interventional therapy of resistant hypertension // J. Hypertens. - 2012. - Vol. 30. - P. 837-841.
  11. Witkowski A., Prejbisz A., Florczak E. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea // Hypertension. - 2011. - Vol. 58. - P. 559-565.

Copyright (c) 2014 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies