JAHA:难治性高血压的患病率和临床特点分析!

2017-12-08 xing.T MedSci原创

由此可见,RfH的患病率较低,与RH患者相比,这些患者有更高的心血管风险。四分之一的RfH患者有正常的24小时血压和较少的靶器官损害,从而表明动态血压监测在难治性患者中指导降压治疗的重要性。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在估计难治性高血压(RfH)的患病率,并确定这些患者与顽固性高血压(RH)患者的临床差异。其次,研究人员评估了白大衣性RfH的患病率以及真正的和白大衣性RfH患者的临床差异。
 
研究人员对含有70997名高血压患者的西班牙动态血压监测数据库进行分析。通过诊室血压升高(≥140和/或90mmHg)且至少服用3个(RH)和5个(RfH)抗高血压药物治疗来定义RH和RfH。白大衣性RfH的定义为24‐小时血压正常(小于130/80mmHg)。
 
该研究共有11972名(16.9%)患者符合RH的标准,并且955名(1.4%)患者被认为具有RfH。与RH患者相比,RfH患者更年轻、男性更多,在调整年龄和性别后,靶器官损害和心血管疾病患病率增加。白大衣性RfH的患病率低于白大衣性RH(26.7% vs. 37.1%,P<0.001)。白大衣性RfH,与那些真正RfH的患者相比,左心室肥厚(22% vs. 29.7%;P=0.018)和微量白蛋白尿(28.3% vs. 42.9%;P=0.047)的患病率更低。

由此可见,RfH的患病率较低,与RH患者相比,这些患者有更高的心血管风险。四分之一的RfH患者有正常的24小时血压和较少的靶器官损害,从而表明动态血压监测在难治性患者中指导降压治疗的重要性。

原始出处:

 
Pedro Armario, et al. Prevalence and Clinical Characteristics of Refractory Hypertension.JAHA.2017. https://doi.org/10.1161/JAHA.117.007365


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1933885, encodeId=b1ec1933885e9, content=<a href='/topic/show?id=7c1c2288877' target=_blank style='color:#2F92EE;'>#临床特点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22888, encryptionId=7c1c2288877, topicName=临床特点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3679417, createdName=feather78, createdTime=Thu May 31 09:01:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250512, encodeId=ec85125051299, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267644, encodeId=7c2d126e64405, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528417, encodeId=e799152841e49, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267788, encodeId=b44826e78834, content=非常好.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Dec 08 09:21:52 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1933885, encodeId=b1ec1933885e9, content=<a href='/topic/show?id=7c1c2288877' target=_blank style='color:#2F92EE;'>#临床特点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22888, encryptionId=7c1c2288877, topicName=临床特点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3679417, createdName=feather78, createdTime=Thu May 31 09:01:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250512, encodeId=ec85125051299, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267644, encodeId=7c2d126e64405, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528417, encodeId=e799152841e49, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267788, encodeId=b44826e78834, content=非常好.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Dec 08 09:21:52 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1933885, encodeId=b1ec1933885e9, content=<a href='/topic/show?id=7c1c2288877' target=_blank style='color:#2F92EE;'>#临床特点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22888, encryptionId=7c1c2288877, topicName=临床特点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3679417, createdName=feather78, createdTime=Thu May 31 09:01:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250512, encodeId=ec85125051299, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267644, encodeId=7c2d126e64405, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528417, encodeId=e799152841e49, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267788, encodeId=b44826e78834, content=非常好.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Dec 08 09:21:52 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2017-12-10 zhaohui6731
  4. [GetPortalCommentsPageByObjectIdResponse(id=1933885, encodeId=b1ec1933885e9, content=<a href='/topic/show?id=7c1c2288877' target=_blank style='color:#2F92EE;'>#临床特点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22888, encryptionId=7c1c2288877, topicName=临床特点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3679417, createdName=feather78, createdTime=Thu May 31 09:01:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250512, encodeId=ec85125051299, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267644, encodeId=7c2d126e64405, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528417, encodeId=e799152841e49, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267788, encodeId=b44826e78834, content=非常好.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Dec 08 09:21:52 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2017-12-10 freve
  5. [GetPortalCommentsPageByObjectIdResponse(id=1933885, encodeId=b1ec1933885e9, content=<a href='/topic/show?id=7c1c2288877' target=_blank style='color:#2F92EE;'>#临床特点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22888, encryptionId=7c1c2288877, topicName=临床特点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3679417, createdName=feather78, createdTime=Thu May 31 09:01:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250512, encodeId=ec85125051299, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267644, encodeId=7c2d126e64405, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528417, encodeId=e799152841e49, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Dec 10 00:01:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267788, encodeId=b44826e78834, content=非常好.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Dec 08 09:21:52 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2017-12-08 swfzhanggui

    非常好.谢谢分享.

    0

相关资讯

BMJ:1995~2015英国难治性高血压的患病和发病趋势如何?

2017年9月,发表在《BMJ》上的一项队列研究,考察了1995~2015年接受治疗的英国高血压人群中,难治性高血压的发病率和患病率情况。研究结果表明:近年来,难治性高血压患病率变得平稳并下降,与2004年起的发病率降低相一致。

2016FSH/FSC专家共识声明——难治性高血压的管理发布

2016年1月,法国高血压学会(French Society of Hypertension)联合法国心血管学会(FSC,French Society of Cardiology)共同发布了难治性高血压的管理共识。获取全文:下载地址:指南下载 (需要扣积分2分, 梅斯医学APP免积分下载)

盘点:关于难治性高血压,不得不知的那些研究

难治性高血压是指在尽管服用3种或3种以上的降压药后血压仍然偏高的一种危险疾病。随着老龄化的来临和肥胖的持续流行,估计难治性高血压的患病仍将增加。本文中,梅斯医学小编列了有关难治性高血压的近期研究,供大学学习参考。【1】Hypertension:慢性肾病患者难治性高血压的发生率较高,预后不好慢性肾脏病患者中难治性高血压(ATRH)和临床结果的关系尚未研究清楚。研究者分析慢性肾功能不全队列研究(C

Hypertension:年轻难治性高血压患者的危险因素及表型分析!

在顽固性高血压患者中,年轻患者有一个独特的表型,相比于老年患者,其特征是重叠的危险因素和合并症,包括肥胖、高醛固酮和高膳食钠摄入量

Hypertension:难治性高血压患者暂时停降压药安全吗?

总之,对高血压诊断评估时,停止服用抗高血压药物并不增加心血管事件的急性风险,但需要在一个具有适当的程序和监测安全的专业医院进行。

难治性高血压怎么办?指南给你出招!

高血压史导致心脑血管疾病和全因死亡率的主要病因。并且也是健康支出的主要影响因素。有65%的难治性高血压患者认为较高的血压水平是最严重的健康威胁。目前高血压的治疗难点主要为:假性耐药性高血压(5-20%)、耐药性高血压(2-5%)、二级高血压(3-5%)以及服用三种以上降压药物控制的高血压。