Rezistentna hipertenzija i centralni krvni tlak

master's thesis

• Title (english): Resistant hypertension and central blood pressure
• Author: Tina Marketin
• Mentor: Ingrid Prkačin (mentor)
• Committee member: Mario Laganović (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

Hipertenzija je najčešća kronična bolest suvremenog doba. Kada unatoč istovremenoj primjeni pune doze tri antihipertenzivna lijeka od kojih je jedan diuretik ne uspije postizanje ciljnih vrijednosti krvnog tlaka tada govorimo o rezistentnoj hipertenziji. Za dijagnozu rezistentne hipertenziije važno je isključiti sekundarne uzroke hipertenzije te pseudorezistentnu hipertenziju. Od velikog značaja je i kontinuirano mjerenje arterijskog tlaka kroz 24 sata kako bi se utvrdile promjene krvnog tlaka tijekom noći. Uočeno je da su promjene krvnog tlaka noću od velike važnosti za procjenu kardiovaskularnog rizika. Česti komorbiditeti pacijenata s rezistentnom hipertenzijom su šećerna bolest, hiperlipidemija i pretilost. Zbog navedenih komorbiditeta nužna je procjena oštećenja ciljnih organa. Terapiju antihipertenzivima potrebno je primjeniti prema najnovijim saznanjima i u optimalnim dozama. Centralni krvni tlak je tlak mjeren na području centralnih arterija što uključuje aortu i zajedničku karotidnu arteriju. Mjeri se invazivnim i neinvazivnim metodama. Važan je indikator budućih kardiovaskularnih događaja i oštećenja ciljnih organa kod pacijenata s rezistentnom hipertenzijom. Sam porast centralnog tlaka pulsa značajan je uzročnik oštećenja arterija mozga time i nastanka cerebrovaskularnog incidenta. Antihipertenzivni lijekovi mogu imati različiti učinak na sniženje centralnog krvnog tlaka u odnosu na sniženje perifernog krvnog tlaka.

Abstract (english)

Hypertension is the most common chronic disease of the modern age. If we fail to achive the target blood pressure despite the simultaneous full dosage of three antihypertensive drugs, one of which is diuretic, then resistant hypertension is diagnosed. For the diagnosis of resistant hypertension it is important to exclude secondary causes of hypertension and pseudo-resistant hypertension. Continuous measurement of arterial pressure over 24 hours to determine changes in blood pressure during the night is of great importance. It has been determined that changes in blood pressure that occur at night can be used to evaluate cardiovascular risk. Frequent comorbidities of patients with resistant hypertension include diabetes mellitus, hyperlipidemia, obesity. Due to the above mentioned comorbidities, it is necessary to estimate the damage of the target organs. Antihypertensive therapy should be given according to the latest findings and at optimal doses. Central blood pressure is the pressure measured in the area of central arteries including the aorta and common carotid artery. It is measured by invasive and non-invasive methods. It is also an important indicator of future cardiovascular events and damage to target organs in patients with resistant hypertension. The increase in central pulse pressure is a major cause of damage to the cerebral arteries that can lead to cerebrovascular incident. Antihypertensive drugs may have a different effect on lowering central blood pressure compared to decreasing peripheral blood pressure.

• Keywords: rezistentna hipertenzija; centralni krvni tlak
• Keywords (english): resistant hypertension; central blood pressure
• Language: croatian
• URN:NBN: urn:nbn:hr:105:778087
• 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: 2020-02-25 08:51:21