HIPERTENSIUNEA ARTERIALĂ REZISTENTĂ: REPERE DE DIAGNOSTIC ȘI TRATAMENT CONTEMPORAN
DOI:
https://doi.org/10.52692/1857-0011.2025.1-81.12Cuvinte cheie:
hipertensiune arterială rezistentă, denervarea renalăRezumat
Hipertensiunea arterială rămâne principalul risc cardiovascular la nivel mondial. Cel mai recent Raport Global al Organizației Mondiale a Sănătății (OMS) privind Hipertensiunea arterială a indicat că numărul de pacienți hipertensivi aproape s-a dublat în ultimele trei decenii, cu o creștere anuală a deceselor, a dizabilității și a costurilor aferente. De asemenea, este important de menționat că un număr tot mai mare de pacienți hipertensivi, în ciuda utilizării a trei sau mai multe medicamente, nu ating o normalizare a tensiunii arteriale, definind astfel scenariul clinic al hipertensiunii arteriale rezistente.Pentru a confirma prezența hipertensiunii arteriale rezistente, trebuie excluse diverse cauze ale hipertensiunii arteriale pseudo-rezistente și hipertensiunea arterială secundară. Controlul inadecvat al tensiunii arteriale trebuie confirmat prin măsurarea tensiunii arteriale în afara cabinetului medical. Hipertensiunea arterială rezistentă afectează aproximativ 5% din populația hipertensivă și este asociată cu o morbiditate și mortalitate cardiovasculară crescută. Managementul acesteia cuprinde intervenții asupra stilului de viață și optimizarea terapiei medicamentoase actuale. Medicamentele suplimentare trebuie introduse secvențial dacă TA rămâne necontrolată, iar denervarea renală poate fi luată în considerare ca o opțiune de tratament suplimentară. Cu toate acestea, obținerea unui control optim al tensiunii arteriale rămâne o provocare în acest context. Datele prezentate fac parte componentă a reviului de literatură/rezultatele obținute în cadrul proiectului instituțional cu acronimul DIAFEREZIS.
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