Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27381561
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27381561
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Trends+Cardiovasc+Med
2016 ; 26
(8
): 700-706
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Emerging concepts for patients with treatment-resistant hypertension
#MMPMID27381561
Eirin A
; Textor SC
; Lerman LO
Trends Cardiovasc Med
2016[Nov]; 26
(8
): 700-706
PMID27381561
show ga
Treatment-resistant hypertension (TRH) is defined as elevated blood pressure
despite treatment with three properly dosed antihypertensive drugs, and is
associated with adverse cardiovascular and renal outcomes and increased
mortality. Treatment of patients with TRH focuses on maximizing the doses of
antihypertensive drugs and adding drugs with complementary mechanisms of action,
including a combination of angiotensin-converting enzyme inhibitors or
angiotensin-receptor blockers, calcium channel blockers, and thiazide-like
diuretics. Randomized clinical trials have demonstrated the efficacy of the
mineralocorticoid receptor antagonist spironolactone as a fourth-line therapy for
patients with TRH. Other pharmacologic considerations include adding ?-blockers,
combined ?-?-blockers, centrally acting ?-agonists, or direct vasodilators.
However, a small, but important subset of patients remain hypertensive despite
combination regimens with multiple antihypertensive drugs, underscoring the need
for novel blood pressure-lowering therapies. Over recent years, alternative
approaches for treating TRH have emerged, including agonists of natriuretic
peptides, endothelin-receptor antagonists, and additional vasoactive drugs.
Lastly, device-based interventions, such as renal denervation or carotid
baroreflex activation, may supplement drug therapy for these patients. This
review summarizes current knowledge on the management of TRH, with focus on novel
therapeutic strategies designed to achieve optimal blood pressure control.