摘要

Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). 



	



	Recent findings suggest that the former may be due to an alteration in the renin-angiotensin-aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. 



	



	It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients' varying response to CPAP treatment.

译文

高血压是最常见的心血管危险因素之一。高血压患者人群包括一些血压水平特别难以控制的表型,从而使他们处于更高的心血管风险中。对于所谓的抵抗性高血压(RH)和难治性高血压(RfH)尤其如此。
	
	
		

	
	
		最近的发现表明,前者可能是由于肾素-血管紧张素-醛固酮轴的改变,而后者似乎与交感神经过度激活密切相关。阻塞性睡眠呼吸暂停(OSA)患者也激活了这两种病理生理机制。因此,不足为奇的是,RH和RfH患者中OSA的患病率很高(如几项研究所反映),并且连续气道正压通气(CPAP)治疗能够在临床上显着降低血压水平。这两组高血压患者。
	
	
		

	
因此,有必要将对OSA可能存在的研究纳入对RH和RfH患者的多维治疗(生活方式的改变,肥胖症的控制和药物治疗)的研究中,因为这是一种可以治疗的疾病。还有许多问题有待解决,特别是关于RH / RfH和OSA患者的理想治疗组合(药物,肾脏去神经支配,CPAP治疗)以及患者对CPAP治疗的不同反应。

Refractory hypertension(RH)

心血管 顽固性高血压或抵抗性高血压 疾病
概述  :  

难治性高血压(RH)是指使用足够剂量且合理的3种或3种以上抗高血压药(其中应包括一种利尿剂),仍不能将收缩压和舒张压控制在目标水平的特殊类型的高血压。又称顽固性高血压或抵抗性高血压。高血压患者中的发生率3.0%~32.5%,且常随病情加重而增高。血压的目标水平在不同人群有不同标准:一般人群血压<140/90mmHg;合并糖尿病或慢性肾脏病[肾小球滤过率<60ml/(min・1.73m2)或血肌酐水平>133μmol/L(男性)、>111.5μmo

Refractory 英 [rɪˈfræktəri]  美 [rɪˈfræktəri] 

释   义   adj. 难治的;难熔的;不听话的

n. 倔强的人;耐火物质

短   语   refractory material 耐火材料;耐热材料;难熔物质

refractory brick 耐火砖

同根词   n. refractoriness 耐火性;耐熔性;不应性

例    句   Because they are not metabolised, these molecules are referred to as “refractory”. 因为这些分子不能被代谢,所以被称为“难解质”。

 

Hypertension 英 [ˌhaɪpəˈtenʃn]  美 [ˌhaɪpərˈtenʃn] 

释   义   n. 高血压;过度紧张

短   语   primary hypertension 原发性高血压

renovascular hypertension 肾血管性高血压

同根词   n. hypertrophy [病理] 肥大;过度增大

hypertensive 高血压患者

例    句   Hypertension and high cholesterol can be controlled. 高血压和高胆固醇可以控制。

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