Etiologija, dijagnostika, liječenje i prevencija sekundarne hipertenzije

master's thesis

• Title (english): Etiology, diagnostics, treatment and prevention of secondary hypertension
• Author: Andrija Matijević
• Mentor: Tonko Gulin (mentor)
• Committee member: Matias Trbušić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tonko Gulin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Sekundarnom hipertenzijom nazivamo povišenje krvnog tlaka kojemu možemo odrediti uzrok. Od ukupnog broja hipertoničara, između 5 i 10% pacijenata boluje od sekundarne hipertenzije. Etiološki, uzročnike rasta tlaka možemo podijeliti na bubrežne, endokrine, vaskularne i ostale uzroke. Mehanizmi podizanja tlaka su raznoliki, a najčešće su zaslužni slijedeći poremećaji: pojačana simpatička aktivnost s posljedičnom vazokonstrikcijom, povišenje vrijednosti angiotenzina i aldosterona s retencijom soli i vazokonstrikcijom te poremećena vaskularna reaktivnost sa smanjenom produkcijom NO i povišenim vrijednostima endotelina. Dijagnostika sekundarne hipertenzije započinje dobrom anamnezom i statusom, koji mogu isključiti ili skrenuti pozornost na specifične nokse odgovorne za razvitak bolesti. Daljnja dijagnostička obrada sastoji se od laboratorijskih i slikovnih metoda koje nam potvrđuju dijagnozu. Uz to, za opstrukrivnu apneju u snu, specifičan uzrok sekundarne hipertenzije, dijagnostički nam je bitna polisomnografija. Kod liječenja, bitno je prepoznati i liječiti eventualne hipertenzivne epizode koje mogu imati ozbiljne posljedice na zdravlje pacijenta. Općeniti je modalitet liječenja kod sekundarne hipertenzije antihipertenzivna terapija i liječenje osnovnog uzroka bolesti. Specifična prevencija sekundarne hipertenzije ne postoji. Ipak, smanjenje tjelesne težine, pravilna prehrana, izbjegavanje konzumacije alkohola i pušenja te fizička aktivnost doprinose nižim vrijednostima krvnog tlaka te se mogu preporučiti svim pacijentima kako bi, koliko je u njihovoj moći, prevenirali eventualni razvoj bolesti.

Abstract (english)

Secondary hypertension is a condition with high blood pressure with an identifiable cause. Of the total number of patients with hypertension, between 5 and 10% of patients have secondary hypertension. Etiologically, causes for the elevation of the blood pressure can be divided into renal, endocrine, vascular and other. The mechanisms responsible for the blood-pressure growth are various, most often due to these disorders: increased sympathetic activity with consequent vasoconstriction, increased levels of angiotensin and aldosterone with salt retention, and vasoconstriction, and impeded vascular reactivity with reduced production of NO and increased endothelin activity. Diagnostics of secondary hypertension start with a well-taken patient's history and thorough physical exam that can either exclude or draw attention to certain causes. Further diagnostic procedures consist of laboratory and imaging methods that can confirm our suspected diagnosis. Besides that, for Obstructive sleep apnea, a specific cause of secondary hypertension, polysomnography is a vital diagnostic tool. Treatment-wise, it is important to identify and treat eventual hypertensive episodes that can have serious consequences on a patient's health. The regular modality of treatment is antihypertensive therapy with the specific treatment for the basal cause of the disease. Specific prevention of secondary hypertension does not exist. Nevertheless, reducing body weight, proper diet, no alcohol or cigarette consumption, and physical activity benefit the reduction of blood pressure, and should be recommended to all of the patients.

• Keywords: Aldosteron; Angiotenzin; Krvni tlak; Sekundarna hipertenzija
• Keywords (english): Aldosterone; Angiotensin; Blood pressure; Secondary hypertension
• Language: croatian
• URN:NBN: urn:nbn:hr:105:643575
• 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: 2023-01-19 09:19:38