Kontrolirana i nekontrolirana rezistentna hipertenzija

master's thesis

• Title (english): Controlled and uncontrolled resistant hypertension
• Author: Marko Kolić
• Mentor: Ingrid Prkačin (mentor)
• Committee member: Bojan Jelaković (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Ingrid Prkačin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Arterijska hipertenzija jedna je od najčešćih kroničnih bolesti populacije te glavni prediktor povišenog kardiovaskularnog rizika. Rezistentna hipertenzija definira se kao stanje u kojem pacijenti unatoč primjeni tri različita antihipertenzivna lijeka od kojih je jedan diuretik ne postižu ciljne vrijednosti krvnog tlaka. Prevalencija rezistentne hipertenzije meĎu hipertenzivnom populacijom iznosi čak 10-15 %. Za dijagnozu rezistentne hipertenzije potrebno je isključiti moguće sekundarne uzroke (opstruktivna „sleep apnea“, primarni hiperaldosteronizam, stenoza renalne arterije) i pseudorezistentnu hipertenziju (nepravilno mjerenje tlaka, efekt bijele kute i nesuradljivost pacijenata prilikom uzimanja antihipertenzivne terapije), te provesti 24-satno mjerenje krvnog tlaka. Rezistentna hipertenzija može se podijeliti na nekontroliranu i kontroliranu rezistentnu hipertenziju s obzirom na vrijednost krvnog tlaka i broj antihipertenziva u terapiji. Obje, i kontrolirana i nekontrolirana rezistentna hipertenzija su heterogeni i kompleksni sindromi koji se razlikuju po patofiziološkom mehanizmu nastanka i kliničkoj prezentaciji. Liječenje uključuje promjene životnih navika i farmakološku terapiju, a kod osoba kod kojih unatoč adekvatnoj terapiji krvni tlak ostaje iznad ciljnih vrijednosti treba razmotriti interventne metode liječenja poput renalne denervacije.

Abstract (english)

Arterial hypertension is one of the most common chronic diseases and main predictor of high cardiovascular risk. Resistant hypertension is defined as a state in which blood pressure remains uncontrolled despite concurrent use of three antihypertensive drugs of which one should be diuretic. The prevalence of resistant hypertension within hypertensive population is even 10-15 %. In diagnostic procedure for resistant hypertension, possible secondary causes (obstructive sleep apnea, primary aldosteronism, renal artery stenosis) and pseudoresistant hypertension (inaccurate measurement of blood pressure, white coat effect, poor adherence to antihypertensive therapy) should be excluded, and also 24-hour ambulatory blood pressure monitoring should be conducted. Resistant hypertension is divided in two major groups according to blood pressure and number of drugs taken: controlled and uncontrolled resistant hypertension. Both controlled an uncontrolled resistant hypertension are heterogenic and complex syndromes which differentiate by pathophysiological mechanism of disease and clinical expression. Treatment strategy includes lifestyle changes and antihypertensive therapy, but if blood pressure remains uncontrolled renal denervation therapy should be considered.

• Keywords: rezistentna hipertenzija; krvni tlak; renalna denervacija
• Keywords (english): resistant hypertension; blood pressure; renal denervation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:086751
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-02-24 14:49:33