Expert Review of Cardiovascular Therapy最新文献

Risk management of patients with multiple CVDs: what are the best practices? 多重心血管疾病患者的风险管理：最佳实践是什么？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-11-19 DOI: 10.1080/14779072.2024.2427634

Amer Harky, Roshni S K Patel, Maya Yien, Abdullah Khaled, Dang Nguyen, Sakshi Roy, Mohamed Zeinah

{"title":"Risk management of patients with multiple CVDs: what are the best practices?","authors":"Amer Harky, Roshni S K Patel, Maya Yien, Abdullah Khaled, Dang Nguyen, Sakshi Roy, Mohamed Zeinah","doi":"10.1080/14779072.2024.2427634","DOIUrl":"10.1080/14779072.2024.2427634","url":null,"abstract":"Introduction: Managing patients with multiple risk factors for CVDs can present distinct challenges for healthcare providers, therefore addressing them can be paramount to optimize patient care.Areas covered: This narrative review explores the burden that CVDs place on healthcare systems as well as how we can best optimize the risk management of these patients. Through a comprehensive review of literature, guidelines and clinical studies, this paper explores various approaches to risk management, lifestyle modifications and pharmacological interventions utilized in the management of CVDs. Furthermore, emerging technologies such as machine learning (ML) are discussed, highlighting potential opportunities for future research. By reviewing existing recommendations and evidence, this paper aims to provide insight into optimizing strategies and improving the outcomes for patients with multiple CVDs.Expert opinion: Optimizing risk factors can have a significant impact on patient outcomes, as such each patient should have a clear plan on how to manage these risk factors to minimize adverse healthcare results.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary review of the evolution of various treatment modalities for mitral regurgitation. 二尖瓣反流各种治疗方法演变的当代回顾。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-11-16 DOI: 10.1080/14779072.2024.2427622

Prasanna Sengodan, Ahmed Younes, Neeraj Shah, Ahmed Maraey, W Randolph Chitwood, Assad Movahed

{"title":"Contemporary review of the evolution of various treatment modalities for mitral regurgitation.","authors":"Prasanna Sengodan, Ahmed Younes, Neeraj Shah, Ahmed Maraey, W Randolph Chitwood, Assad Movahed","doi":"10.1080/14779072.2024.2427622","DOIUrl":"https://doi.org/10.1080/14779072.2024.2427622","url":null,"abstract":"Introduction: Mitral regurgitation is one of the commonest valvular heart diseases for which there have been several innovative treatment strategies that have developed over the last several decades. We describe the various treatment modalities that have been used for the last several decades. All articles in PubMed, Cochran and Embase were screened from inception to August 2024 for the following - 'Mitral valve regurgitation' 'Mitral valve repair' 'Mitral valve replacement' 'Robotic mitral surgery' 'Transcatheter mitral valve repair.'Areas covered: Mitral regurgitation (MR) is classified into primary and secondary MR. Causes of primary MR include degenerative disease, rheumatic heart disease, and infective endocarditis. Secondary MR is observed in the setting of left ventricle (LV) pathology, including ischemic or dilated cardiomyopathy. In secondary MR, annular dilation, papillary muscle displacement, tethering of chordae tendineae and/or mitral valve (MV) leaflets result in leaflet restriction and malcoaptation.Expert opinion: In this review, we discuss various modalities for treatment of mitral regurgitation, as well as newer treatment options for MR including robotic MV repair and other minimally invasive procedures. Several ongoing randomized controlled trials in this topic will help shed more light and provide guidance to deliver the optimal care for our patients.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of hypertension in the elderly: target the lowest well tolerated blood pressure. 治疗老年人高血压：以可耐受的最低血压为目标。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-11-07 DOI: 10.1080/14779072.2024.2427637

Fabio Angeli, Paolo Verdecchia, Alessio Mazzieri, Gianpaolo Reboldi

{"title":"Treatment of hypertension in the elderly: target the lowest well tolerated blood pressure.","authors":"Fabio Angeli, Paolo Verdecchia, Alessio Mazzieri, Gianpaolo Reboldi","doi":"10.1080/14779072.2024.2427637","DOIUrl":"https://doi.org/10.1080/14779072.2024.2427637","url":null,"abstract":"Introduction: Clinical trials have shown that antihypertensive treatment provides substantial benefits in older people. However, many challenges remain, including the ideal blood pressure (BP) target to be achieved. Because the elderly population is particularly vulnerable to adverse events, BP control should be carefully managed. Some studies have evaluated the cardiovascular effects of different BP targets in older patients, with mixed results and uncertainty about the most appropriate BP target. However, available data from pooled analyses suggest that intensive BP lowering provides greater cardiovascular protection than less intensive strategies in elderly hypertensive patients.Areas covered: Understanding the balance between the risks and benefits of intensive BP targets and individualizing treatment is essential to ensure that older hypertensive patients receive appropriate treatment to reduce the risk of cardiovascular complications. To this purpose, we reviewed data from clinical trials which investigated the protective effects of blood pressure lowering drugs in elderly hypertensive patients aged ≥65 years (publication before 31 August 2024, using Medline, SCOPUS, and Web of Science databases).Expert opinion: Current evidence suggests that age does not preclude an aggressive strategy for treating hypertension in elderly patients. Being 'tolerant' with one hand and 'intensive' with the other should become a universal standard in the management of elderly hypertensive patients. In conclusion, the lowest well-tolerated BP could be a simple and universally applicable BP target in the management of hypertensive patients, including the elderly.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-term and long-term outcomes of cardiac arrhythmias in patients with cardiogenic shock. 心源性休克患者心律失常的短期和长期预后。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-09-30 DOI: 10.1080/14779072.2024.2409437

Jean-Claude Asaker, Mridul Bansal, Aryan Mehta, Melvin G Joice, Rachna Kataria, Marwan Saad, J Dawn Abbott, Saraschandra Vallabhajosyula

{"title":"Short-term and long-term outcomes of cardiac arrhythmias in patients with cardiogenic shock.","authors":"Jean-Claude Asaker, Mridul Bansal, Aryan Mehta, Melvin G Joice, Rachna Kataria, Marwan Saad, J Dawn Abbott, Saraschandra Vallabhajosyula","doi":"10.1080/14779072.2024.2409437","DOIUrl":"10.1080/14779072.2024.2409437","url":null,"abstract":"Introduction: Cardiogenic shock is severe circulatory failure that results in significant in-hospital mortality, related morbidity, and economic burden. Patients with cardiogenic shock are at high risk for atrial and ventricular arrhythmias, particularly within the subset of patients with an overlap of cardiogenic shock and cardiac arrest.Areas covered: This review article will explore the prevalence, definition, management, and outcomes of common arrhythmias in patients with cardiogenic shock. This review will describe the pathophysiology of arrhythmia in cardiogenic shock and the impact of inotropic agents on increased arrhythmogenicity. In addition to medical management, focused assessment of mechanical circulatory support, radiofrequency ablation, deep sedation, and stellate ganglion block will be provided.Expert opinion: We will navigate the limited data and describe the prognostic impacts of arrhythmia. Finally, we will conclude the review with a discussion of prevention strategies, research limitations, and future research directions.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"537-551"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nattokinase as an adjuvant therapeutic strategy for non-communicable diseases: a review of fibrinolytic, antithrombotic, anti-inflammatory, and antioxidant effects. 纳豆激酶作为非传染性疾病的辅助治疗策略：纤维蛋白溶解、抗血栓、抗炎和抗氧化作用综述。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-10-15 DOI: 10.1080/14779072.2024.2416663

Mariana Granito, Livia Alvarenga, Marcia Ribeiro, Priscila Carvalhosa, Thaysi Andrade, Claudio Tinoco Mesquita, Milena Barcza Stockler-Pinto, Denise Mafra, Ludmila Fmf Cardozo

{"title":"Nattokinase as an adjuvant therapeutic strategy for non-communicable diseases: a review of fibrinolytic, antithrombotic, anti-inflammatory, and antioxidant effects.","authors":"Mariana Granito, Livia Alvarenga, Marcia Ribeiro, Priscila Carvalhosa, Thaysi Andrade, Claudio Tinoco Mesquita, Milena Barcza Stockler-Pinto, Denise Mafra, Ludmila Fmf Cardozo","doi":"10.1080/14779072.2024.2416663","DOIUrl":"10.1080/14779072.2024.2416663","url":null,"abstract":"Introduction: Nattokinase (NK) is the primary ingredient of natto, a traditional Asian food made from fermented soybean by Bacillus subtilis natto. Studies have shown that natto reduces the risk of cardiovascular disease (CVD) mortality due to its fibrinolytic and antithrombotic properties. A new field of studies also demonstrates that NK can mitigate molecular pathways related to inflammation and oxidative stress and can be considered an adjuvant strategy for use in many non-communicable diseases (NCDs). This paper is a narrative review of the literature. A search was conducted in PubMed and ScienceDirect up to July 2024.Areas covered: This review discusses the possible effects of NK on mitigating the common complications of NCDs, such as inflammation and oxidative stress. In addition, it provides an update on the most addressed areas related to NK's fibrinolytic and antithrombotic activities.Expert opinion: Due to the fibrinolytic and antithrombotic activity of nattokinase, and more recently added to the anti-inflammatory and antioxidant effects, this enzyme can be used as a new adjuvant therapeutic strategy to mitigate inflammation and oxidative stress in NCDs, including CVD.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"565-574"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managing elderly patients with atrial fibrillation and multimorbidity: call for a systematic approach. 管理患有心房颤动和多病的老年患者：呼吁采用系统性方法。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-10-24 DOI: 10.1080/14779072.2024.2416666

Colinda van Deutekom, Jeroen M L Hendriks, Marius Myrstad, Isabelle C Van Gelder, Michiel Rienstra

{"title":"Managing elderly patients with atrial fibrillation and multimorbidity: call for a systematic approach.","authors":"Colinda van Deutekom, Jeroen M L Hendriks, Marius Myrstad, Isabelle C Van Gelder, Michiel Rienstra","doi":"10.1080/14779072.2024.2416666","DOIUrl":"10.1080/14779072.2024.2416666","url":null,"abstract":"Introduction: Atrial fibrillation (AF) is often accompanied by comorbidities. Not only cardiovascular but also non-cardiovascular comorbidities have been associated with AF. Multimorbidity is therefore a common finding in patients with AF, especially in elderly patients. Multimorbidity is associated with adverse outcomes, adds complexity to AF management, and poses a significant burden on healthcare costs. It is expected that the prevalence of elderly patients with multimorbidity will increase significantly. It is therefore crucial to outline implications for clinical practice and guide comprehensive multimorbidity management.Areas covered: This perspective article outlines multimorbidity in AF and the importance of comprehensive comorbidity management. It addresses current clinical practice guided by international guidelines and the need for integrated care including a patient-centered focus, comprehensive AF management, coordinated multidisciplinary care, and supporting technology. Moreover, it proposes a novel model of care delivery following a systematic approach to multimorbidity management.Expert opinion: Providing comprehensive care by means of a multidisciplinary team and patient engagement is crucial to provide optimal personalized care for elderly patients with AF and multimorbidity. A systematic integrated care approach seems promising, but further studies are needed to investigate the feasibility of a systematic approach and prioritization of comorbidity management in patients with multimorbidity.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"523-536"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of eprosartan in the management of essential hypertension: literature review and expert opinion. 表沙坦在治疗原发性高血压中的作用：文献综述和专家意见。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-10-25 DOI: 10.1080/14779072.2024.2418298

Carlos Escobar, Pilar Mazón, Claudio Rivadulla, Shukrath Chandrappa

{"title":"The role of eprosartan in the management of essential hypertension: literature review and expert opinion.","authors":"Carlos Escobar, Pilar Mazón, Claudio Rivadulla, Shukrath Chandrappa","doi":"10.1080/14779072.2024.2418298","DOIUrl":"10.1080/14779072.2024.2418298","url":null,"abstract":"Introduction: Eprosartan is an angiotensin receptor blocker (ARB) used for management of essential hypertension. With unique pharmacological characteristics, dual action mechanism, and clinical effectiveness, eprosartan offers additional advantages over other ARBs in specific patient populations.Areas covered: A comprehensive review of the literature was performed across publicly available databases, with no time limitations, to ensure the inclusion of all relevant studies. The review focuses on presenting the efficacy and safety profile of eprosartan, alone or in combination with other agents. Additionally, it explores the etiology of hypertension concerning the structure and function of angiotensin II type 1 receptors. Further, the efficacy of eprosartan in special populations and its additional benefits are also discussed.Expert opinion: Eprosartan effectively reduces blood pressure (BP), with a 24-hour BP-lowering effect at 600 mg/day. Eprosartan demonstrates similar or better efficacy than other ARBs, such as telmisartan and losartan, particularly in managing coagulation-related abnormalities and peripheral resistance. In combination therapy, eprosartan with hydrochlorothiazide significantly enhances BP reduction. Eprosartan is well-tolerated, with a low incidence of adverse events, making it a reliable choice for long-term hypertension management across various patient populations, such as those with comorbid diabetes and renal disease and older adults.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"575-587"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What are the early warning signs of myocarditis during the pathway of care? 在治疗过程中，心肌炎有哪些早期预警信号？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-10-24 DOI: 10.1080/14779072.2024.2416676

Yasar Sattar, Aimen Shafiq, Sahithi Sharma, Krutarth Pandya, Karthik Gonuguntla, Harshith Thyagaturu, Fnu Zafrullah, Sudarshan Balla

{"title":"What are the early warning signs of myocarditis during the pathway of care?","authors":"Yasar Sattar, Aimen Shafiq, Sahithi Sharma, Krutarth Pandya, Karthik Gonuguntla, Harshith Thyagaturu, Fnu Zafrullah, Sudarshan Balla","doi":"10.1080/14779072.2024.2416676","DOIUrl":"10.1080/14779072.2024.2416676","url":null,"abstract":"Introduction: Myocarditis is an inflammatory disease of the myocardial layer of the heart that can be prone to dilation of chambers with presentation as heart failure secondary to dilated cardiomyopathy. Myocarditis can lead to remodeling and fibrosis that can affect the heart's relaxation-lusitropy and chronotropic function. The current techniques for identifying myocarditis, such as endomyocardial biopsy and imaging, are costly, and intrusive. The current literature aims to identify reliable, accurate, and prognostically educative biomarkers of myocarditis.Areas covered: This review covers the definition, clinical features, diagnostic markers, cardiac imaging, prognosis, and complications of myocarditis. PubMed, Embase, and the Cochrane data bank were searched from inception to 1 January 2024 for relevant articles.Expert opinion: By adopting these diagnostic and prognostic biomarkers, clinicians can have a better comprehension of the progression of the disease and provide early diagnosis and treatment for myocarditis.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"553-563"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transitioning between therapeutic anticoagulants: a clinicians guide to switching patients to or from DOAC therapy. 治疗性抗凝剂之间的转换：临床医生指导患者转用或停用 DOAC 治疗。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-10-01 Epub Date: 2024-11-03 DOI: 10.1080/14779072.2024.2421800

Benilde Cosmi, Michelangelo Sartori

{"title":"Transitioning between therapeutic anticoagulants: a clinicians guide to switching patients to or from DOAC therapy.","authors":"Benilde Cosmi, Michelangelo Sartori","doi":"10.1080/14779072.2024.2421800","DOIUrl":"10.1080/14779072.2024.2421800","url":null,"abstract":"Introduction: The transition to or from direct oral anticoagulants (DOACs) is common in clinical practice.Areas covered: A literature search was conducted on PubMed, Google Scholar, and UpToDate up to March 2024 for conditions and approaches for transitioning from one agent to the other. No randomized clinical trials were retrieved except for two studies regarding switching to DOAC in well-conducted vitamin K antagonist (VKA) therapy. A narrative review was conducted addressing the conditions for switching from one agent to the other, such as thromboembolic events and major bleeding during anticoagulation, development or worsening of kidney or liver failure, initiation of interfering drugs, adverse events such as allergic reactions, frailty, patients' preferences, and affordability. During transitions from one anticoagulant to the other, the risk of both thromboembolic and bleeding complications should be minimized. The current approaches for such transitions are derived from those employed in clinical trials evaluating DOAC and from product information.Expert opinion: Many uncertainties remain regarding those circumstances requiring a change in anticoagulant strategies, as they lack evidence-based guidance. It can be envisaged that the problem of switching to and from DOAC will need additional studies especially addressing the conditions and the best approach to such transitions.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"589-602"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Options for patients with out-of-control blood pressure: after all avenues have been exhausted. 血压失控患者的选择：在用尽所有方法之后。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2024-09-01 Epub Date: 2024-09-11 DOI: 10.1080/14779072.2024.2401875

Weiwei Zeng, Brian Tomlinson

{"title":"Options for patients with out-of-control blood pressure: after all avenues have been exhausted.","authors":"Weiwei Zeng, Brian Tomlinson","doi":"10.1080/14779072.2024.2401875","DOIUrl":"10.1080/14779072.2024.2401875","url":null,"abstract":"Introduction: Uncontrolled hypertension is the leading risk factor for global mortality. Most hypertensive patients can be controlled with standard medication combinations, but some may not respond adequately to ≥3 or even to ≥5 antihypertensive agents.Areas covered: In this review, we summarize the recent literature on difficult-to-treat hypertension identified by a Medline search, and we discuss the options for fourth line and subsequent therapy.Expert opinion: It is essential to confirm resistant hypertension with out-of-office blood pressure measurements and to consider lifestyle factors, adherence to medication and secondary causes of hypertension. When true resistant hypertension is confirmed and blood pressure is not controlled with an optimal triple combination, preferably as a fixed dose combination tablet, spironolactone is usually recommended as the fourth medication. Comorbid conditions should be treated as appropriate with sodium-glucose-cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, sacubitril-valsartan or finerenone. Renal denervation appears to be a useful addition to overcome some of the problems of medication adherence. The endothelin antagonist aprocitentan may be a final option in some countries. Of the drugs in development, the RNA based therapeutics that inhibit angiotensinogen synthesis appear to be some of the most promising.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"459-470"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0