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首页> 外文期刊>The journal of clinical hypertension. >Refractory hypertension: Definition, prevalence, and patient characteristics
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Refractory hypertension: Definition, prevalence, and patient characteristics

机译：难治性高血压：定义，患病率和患者特征

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Among patients with resistant hypertension (RHTN), there are those whose blood pressure (BP) remains uncontrolled in spite of maximal medical therapy. This retrospective analysis aims to characterize these patients with refractory hypertension. Refractory hypertension was defined as BP that remained uncontrolled after ≥3 visits to a hypertension clinic within a minimum 6-month follow-up period. Of the 304 patients referred for RHTN, 29 (9.5%) remained refractory to treatment. Patients with refractory hypertension and those with controlled RHTN had similar aldosterone levels and plasma renin activity (PRA). Patients with refractory hypertension had higher baseline BP (175±23/97±15mmHg vs 158±25/89±15mmHg; P = .001/.005) and heart rate, and higher rates of prior stroke and congestive heart failure. During follow-up, the BP of patients with refractory hypertension remained uncontrolled (168.4±14.8/93.8±17.7mmHg) in spite of use of an average of 6 antihypertensive medications, while those of patients with controlled RHTN decreased to 129.3±11.2/77.6±10.8mmHg. Spironolactone reduced the BP by 12.9±17.8/6.6±13.7mmHg in patients with refractory hypertension and by 24.1±16.7/9.2±12.0mmHg in patients with controlled RHTN. In patients with RHTN, approximately 10% remain refractory to treatment. Similar aldosterone and PRA levels and a diminished response to spironolactone suggest that aldosterone excess does not explain the treatment failure.
机译：在顽固性高血压（RHTN）患者中，尽管进行了最大程度的药物治疗，但仍有一些患者的血压（BP）不受控制。这项回顾性分析旨在确定这些难治性高血压患者的特征。难治性高血压定义为在至少6个月的随访期内≥3次就诊于高血压诊所后仍无法控制的BP。在304例接受RHTN治疗的患者中，有29例（9.5％）仍对治疗无效。难治性高血压患者和RHTN受控患者的醛固酮水平和血浆肾素活性（PRA）相似。难治性高血压患者的基线血压较高（175±23/97±15mmHg vs 158±25/89±15mmHg; P = .001 / .005）和心率，以及先前卒中和充血性心力衰竭的发生率较高。在随访期间，尽管平均使用了6种降压药物，但难治性高血压患者的BP仍不受控制（168.4±14.8 / 93.8±17.7mmHg），而RHTN受控的患者的BP降至129.3±11.2 / 77.6 ±10.8毫米汞柱螺内酯使难治性高血压患者的血压降低12.9±17.8 / 6.6±13.7mmHg，对RHTN控制的患者降低BP 24.1±16.7 / 9.2±12.0mmHg。在RHTN患者中，约有10％的患者对治疗无效。相似的醛固酮和PRA水平以及对螺内酯的反应减弱表明，醛固酮过量不能解释治疗失败的原因。

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