肾脏神经支配作为治疗顽固性高血压的一种新方法:机制、疗效和未来方向。

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE
Kristen Callender, Ikponmwosa Jude Ogieuhi, Victor Oluwatomiwa Ajekiigbe, Boluwaduro Abasiekem Adeyemi, Chinonyelum Emmanuel Agbo, Taiwo Ayokunle Falayi, Atinuke Oladejo, Joan Oluwadamilola Ajayi, Samuel Ajewole, Faith Temiloluwa Adetayo, Oluwatobiloba Samson Fakojo, Adewunmi Akingbola, Ganiyat Adekemi Adeshina
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引用次数: 0

摘要

顽固性高血压是指尽管坚持使用β-受体阻滞剂、钙通道阻滞剂、利尿剂、血管紧张素转换酶抑制剂或血管紧张素转换酶抑制剂等标准药物治疗,但仍出现持续高血压的状态。顽固性高血压与中风、心力衰竭、肾脏疾病和视力丧失的增加有关,因此是目前心血管医学中的一个难题。对于药物治疗无效的高血压患者,肾脏去神经支配(RDN)是一种侵入性治疗策略。因此,该疗法已成为一种可行的替代疗法,本综述将对其进行探讨,并与其他可能的新疗法进行比较。本文还讨论了 RDN 的机制、疗效、安全性和未来发展方向。短期使用 RDN 没有严重副作用的报道,但长期使用会出现肾动脉狭窄和高血压急症等并发症。尽管如此,RDN 仍能使不遵从药物治疗或不耐受药物治疗的患者受益。但也应指出,一些临床研究的结果并不一致。RDN 可作为抵抗性高血压的辅助治疗手段,而非主要治疗手段。后续研究应评估该技术的耐久性,并建立定制方法以安全实施 RDN,同时确定可预测患者预后的特定生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Renal Denervation as a Novel Therapeutic Approach for Resistant Hypertension: Mechanisms, Efficacy and Future Directions.

Resistant hypertension is a state characterized by sustained hypertension despite adherence to the standard pharmacological treatment with beta-blockers, calcium channel blockers, diuretics, and ACE inhibitors or ARBs. Resistant hypertension is a problem now in cardiovascular medicine because of its association with increased stroke, heart failure, kidney disease, and vision loss. Renal denervation (RDN) is an invasive treatment strategy for patients with hypertension who are unresponsive to pharmacological therapy. Therefore, this procedure has become a feasible alternative, and this review explores and compares with other possible novel options. RDN's mechanisms, efficacy, safety, and future directions are also discussed. No serious side effects have been reported in the short-term use of RDN, but some of the complications include renal stenosis and hypertensive urgencies in the long term. Despite this, RDN can benefit patients who are non-compliant with medications or are intolerant. However, it should also be pointed out that some clinical studies have not given consistent results. RDN may be employed as secondary therapy as opposed to the primary line of treatment in resistant hypertension. Subsequent studies should assess the technique's durability and establish customized approaches to deliver RDN safely while determining specific biomarkers that can predict patients' outcomes.

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来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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