Therapierefrakt?re Hypertonie

详细信息    查看全文

• 作者：M. Siekierka-Harreis (1)
  L.C. Rump (1)
  PD Dr. O. Vonend (1)
  
• 关键词：Arterielle Hypertonie ; Therapierefrakt?re Hypertonie ; Renale Denervation ; Baroreflexstimulation ; Sympathikus ; Arterial hypertension ; Refractory hypertension ; Renal denervation ; Baroreflex activation ; Sympathetic nervous system
• 刊名：Der Internist
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：53
• 期：12
• 页码：1411-1419
• 参考文献：1. Calhoun DA, Jones D, Textor S et?al (2008) 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. Hypertension 51:1403-419 CrossRef
  2. Cuspidi C, Macca G, Sampieri L et?al (2001) High prevalence of cardiac and extracardiac target organ damage in refractory hypertension. J?Hypertens 19:2063-070
  3. Lewington S, Clarke R, Qizilbash N et?al (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61?prospective studies. Lancet 360:1903-913 CrossRef
  4. Law MR, Morris JK, Wald NJ (2009) Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147?randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338:b1665 CrossRef
  5. Ouzan J, Perault C, Lincoff AM et?al (2002) The role of spironolactone in the treatment of patients with refractory hypertension. Am J Hypertens 15(4 Pt?1):333-39 CrossRef
  6. Nishizaka MK, Zaman MA, Calhoun DA (2003) Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am J Hypertens 16(11 Pt?1):925-30 CrossRef
  7. Lazich I, Bakris GL (2011) Endothelin antagonism in patients with resistant hypertension and hypertension nephropathy. Contrib Nephrol 172:223-34 CrossRef
  8. Krum H, Schlaich M, Whitbourn R et?al (2009) Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 373:1275-281 CrossRef
  9. Schlaich MP, Sobotka PA, Krum H et?al (2009) Renal denervation as a therapeutic approach for hypertension: novel implications for an old concept. Hypertension 54:1195-201 CrossRef
  10. Symplicity HTN-1 Investigators (2011) Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24?months. Hypertension 57:911-17 CrossRef
  11. Esler MD, Krum H, Sobotka PA et?al (2010) Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 376:1903-909 CrossRef
  12. Schlaich MP, Sobotka PA, Krum H et?al (2009) Renal sympathetic-nerve ablation for uncontrolled hypertension. N?Engl J Med 361:932-34
  13. Vonend O, Antoch G, Rump LC, Blondin D (2012) Secondary rise in blood pressure after renal denervation. Lancet 380:778 CrossRef
  14. Vonend O, Quack I, Rump LC (2012) Differentialdiagnostik der schwer einstellbaren Hypertonie. Nephrologe 7:374-84 CrossRef
  15. Mahfoud F, Vonend O, Bruck H et?al (2011) Expert consensus statement on interventional renal sympathetic denervation for hypertension treatment. Dtsch Med Wochenschr 136:2418 CrossRef
  16. Hering D, Mahfoud F, Walton AS et?al (2012) Renal denervation in moderate to severe CKD. J?Am Soc Nephrol 23:1250-257
  17. Mahfoud F, Cremers B, Janker J et?al (2012) Renal hemodynamics and renal function after catheter-based renal sympathetic denervation in patients with resistant hypertension. Hypertension 60:419-24 CrossRef
  18. Witkowski A, Prejbisz A, Florczak E et?al (2011) Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension 58:559-65 CrossRef
  19. Brandt MC, Mahfoud F, Reda S et?al (2012) Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension. J?Am Coll Cardiol 59:901-09
  20. Ukena C, Mahfoud F, Kindermann I et?al (2011) Cardiorespiratory response to exercise after renal sympathetic denervation in patients with resistant hypertension. J?Am Coll Cardiol 58:1176-182
  21. Kandzari DE, Bhatt DL, Sobotka PA et?al (2012) Catheter-based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN-3 Trial. Clin Cardiol 35:528-35 CrossRef
  22. Kaltenbach B, Franke J, Bertog SC et?al (2012) Renal sympathetic denervation as second-line therapy in mild resistant hypertension: a pilot study. Catheter Cardiovasc Interv (im Druck)
  23. Heusser K, Tank J, Engeli S, Diedrich A et?al (2010) Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension 55:619-26 CrossRef
  24. Scheffers IJ, Kroon AA, Schmidli J et?al (2010) Novel baroreflex activation therapy in resistant hypertension: results of a European multi-center feasibility study. J?Am Coll Cardiol 56:1254-258
  25. Scheffers IJ, Kroon AA, Leeuw PW?de (2010) Carotid baroreflex activation: past, present, and future. Curr Hypertens Rep 12:61-6 CrossRef
  26. Bisognano JD, Bakris G, Nadim MK et?al (2011) Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J?Am Coll Cardiol 58:765-73
  27. Hoppe UC, Brandt MC, Wachter R et?al (2012) Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. J?Am Soc Hypertens 6:270-76
  28. Deutsche Hochdruckliga (2008) Leitlinien zur Behandlung der arteriellen Hypertonie
  29. Moser M, Setaro JF (2006) Clinical practice. Resistant or difficult-to-control hypertension. N?Engl J Med 355:385-92
  30. Buchner N, Vonend O, Rump LC (2006) Pathophysiology of hypertension: what’s new? Herz 31:294-02 CrossRef
  31. Pedrosa RP, Drager LF, Gonzaga CC et?al (2011) Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension 58:811-17 CrossRef
  32. Buchner NJ, Quack I, Woznowski M et?al (2011) Microvascular endothelial dysfunction in obstructive sleep apnea is caused by oxidative stress and improved by continuous positive airway pressure therapy. Respiration 82:409-17 CrossRef
  33. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046-053
  34. Kuhlmann U, Becker HF, Birkhahn M et?al (2000) Sleep-apnea in patients with end-stage renal disease and objective results. Clin Nephrol 53:460-66
  35. Quack I, Fritz A, Rump LC (2010) Sleep apnea syndrome in chronic renal failure. Nephrologe 1:43-8 CrossRef
  36. Vonend O, Rump LC (2006) Normokalemic primary hyperaldosteronism. Dtsch Med Wochenschr 131:H24-7 CrossRef
  37. Conn J (1955) Primary hyperaldosteronism. J?Lab Clin Med 45:661-64
  38. Douma S, Petidis K, Doumas M et?al (2008) Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet 371:1921-926 CrossRef
  39. Funder JW, Carey RM, Fardella C et?al (2008) Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline. J?Clin Endocrinol Metab 93:3266-281
  40. Vonend O, Stegbauer J, Kokulinsky P et?al (2007) Comparison of adrenal imaging and selective adrenal vein sampling in primary hyperaldosteronism. Dtsch Med Wochenschr 132:2436-441 CrossRef
  41. Vonend O, Ockenfels N, Gao X et?al (2011) Adrenal venous sampling: evaluation of the German Conn’s registry. Hypertension 57:990-95 CrossRef
  
• 作者单位：M. Siekierka-Harreis (1)
  L.C. Rump (1)
  PD Dr. O. Vonend (1)
  
  1. Klinik für Nephrologie, Medizinische Fakult?t, Universit?tsklinikum Düsseldorf, Heinrich-Heine-Universit?t, Moorenstr. 5, 40225, Düsseldorf, Deutschland
  
• ISSN：1432-1289

文摘

Sympathetic overexpression can be found in a majority of hypertensive patients. Resistant arterial hypertension requires a targeted diagnostic procedure in order to exclude secondary causes of hypertension which can be treated specifically with established therapies. If secondary reasons are not identified, the antihypertensive medication is already optimal and lifestyle changes have been realized, but still the goal of antihypertensive therapy cannot be achieved, alternative invasive therapy strategies such as renal sympathetic denervation and baroreflex activation have been developed to achieve blood pressure control. These therapies are restricted to specialized centers which treat well-defined patients with therapy-resistant hypertension. Little long-term data concerning safety and efficacy are available for the two strategies. However, they should preferably be used as an ultima-ratio and add-on pathway to conservative procedures when established medication fails to achieve blood pressure control. To date, the effectiveness of the interventional antihypertensive therapies has only been shown on patients with systolic blood pressure over 160?mmHg and a mean oral medication of five drugs.