难治性高血压诊断治疗中国专家共识
孙宁玲,霍勇,王继光,李南方,陶军,李勇,严晓伟,蒋雄京,李学旺
摘要(Abstract)：
<正>1前言难治性高血压(resistant hypertension,RH)是高血压治疗中的一个难点。随着人口老龄化以及肥胖、睡眠呼吸暂停低通气综合征、慢性肾脏病等疾病的增多,RH成为越来越常见的临床问题。血压控制不良会导致心、脑、肾等靶器官损害,从而促进临床血管事件的发生,积极有效地使血压达标
关键词(KeyWords)：
基金项目(Foundation):
作者(Author): 孙宁玲,霍勇,王继光,李南方,陶军,李勇,严晓伟,蒋雄京,李学旺
参考文献(References)：
- [1]Calhoun DA,Jones D,Textor S,et al.Resistant hypertension:diagnosis,evaluation,and treatment.A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research[J].Hypertension,2008,51(6):1403-1419.
- [2]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
- [3]Chobanian AV,Bakris GL,Black HR,et al.Seventh report of the Joint National Committee on prevention,detection,evaluation,and treatment of high blood pressure[J].Hypertension,2003,42(6):1206-1252.
- [4]Dahl f B,Sever PS,Poulter NR,et al.Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required,in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm(ASCOT-BPLA):a multicentre randomised controlled trial[J].Lancet,2005,366(9489):895-906.
- [5]Jamerson K,Weber MA,Bakris GL,et al.Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients[J].N Engl J Med,2008,359(23):2417-2428.
- [6]Schmieder RE,Redon J,Grassi G,et al.ESH position paper:renal denervation-an interventional therapy of resistant hypertension[J].J Hypertens,2012,30(5):837-841.
- [7]Tsioufis C,Kordalis A,Flessas D,et al.Pathophysiology of resistant hypertension:the role of sympathetic nervous system[J].Int J Hypertens,2011,2011:642416.
- [8]Barajas L,Liu L,Powers K.Anatomy of the renal innervation:intrarenal aspects and ganglia of origin[J].Can J Physiol Pharmacol,1992,70(5):735-749.
- [9]Hering D,Mahfoud F,Walton AS,et al.Renal denervation in moderate to severe CKD[J].J Am Soc Nephrol,2012,23(7):1250-1257.
- [10]Laurent S,Schlaich M,Esler M.New drugs,procedures,and devices for hypertension[J].Lancet,2012,380(9841):591-600.
- [11]王文,张维忠,孙宁玲,等.中国血压测量指南[J].中华高血压杂志,2011,19(12):1101-1115.
- [12]Aucott L,Poobalan A,Smith WC,et al.Effects of weight loss in overweight/obese individuals and long-term hyper-tension outcomes:a systematic review[J].Hypertension,2005,45(6):1035-1041.
- [13]Neter JE,Stam BE,Kok FJ,et al.Influence of weight reduction on blood pressure:a meta-analysis of randomized controlled trials[J].Hypertension,2003,42(5):878-884.
- [14]Chobanian AV,Bakris GL,Black HR,et al.The Seventh Report of the Joint National Committee on Prevention,Detection,Evaluation,and Treatment of High Blood Pressure:the JNC7 report[J].JAMA,2003,289(19):2560-2572.
- [15]He FJ,Markandu ND,MacGregor GA.Modest salt reduction lowers blood pressure in isolated systolic hypertension and combined hyper-tension[J].Hypertension,2005,46(1):66-70.
- [16]Vollmer WM,Sacks FM,Ard J,et al.Effects of diet and sodium intake on blood pressure:subgroup analysis of the DASH-sodium trial[J].Ann Intern Med,2001,135(12):1019-1028.
- [17]Singer DR,Markandu ND,Sugden AL,et al.Sodium restriction in hypertensive patients treated with a converting enzyme inhibitor and a thiazide[J].Hypertension,1991,17(6Pt 1):798-803.
- [18]Appel LJ,Moore TJ,Obarzanek E,et al.A clinical trial of the effects of dietary patterns on blood pressure.DASH Collaborative Research Group[J].N Engl J Med,1997,336(16):1117-1124.
- [19]Kokkinos PF,Narayan P,Colleran JA,et al.Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension[J].N Engl J Med,1995,333(22):1462-1467.
- [20]Whelton SP,Chin A,Xin X,et al.Effect of aerobic exercise on blood pressure:a meta-analysis of randomized,controlled trials[J].Ann Intern Med,2002,136(7):493-503.
- [21]Jordan J,Yumuk V,Schlaich M,et al.Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension:obesity and difficult to treat arterial hypertension[J].J Hypertens,2012,30(6):1047-1055.
- [22]DiBonaGF,EslerM.Translationalmedicine:t h e antihypertensive effect of renal denervation[J].Am J Physiol Regul Integr Comp Physiol,2010,298(2):R245-R253.
- [23]Krum H,Schlaich M,Whitbourn R,et al.Catheter-based renal sympathetic denervation for resistant hypertension:a multicentre safety and proof-of-principle cohort study[J].Lancet,2009,373(9671):1275-1281.
- [24]Simplicity HTN-1Investigators.Catheter-based renal sympathetic denervation for resistant hypertension:durability of blood pressure reduction out to24months[J].Hypertension,2011,57(5):911-917.
- [25]Simplicity HTN-2Investigators,Esler MD,Krum H,et al.Renal sympathetic denervation in patients with treatment-resistant hypertension(The Symplicity HTN-2Trial):a randomised controlled trial[J].Lancet,2010,376(9756):1903-1909.