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Acta Medica Colombiana
Print version ISSN 0120-2448
Abstract
MUNOZ, Edison et al. Resistant hypertension Treatment strategies and role of renal sympathetic denervation therapy. Acta Med Colomb [online]. 2014, vol.39, n.1, pp.57-63. ISSN 0120-2448.
Abstract Introduction: hypertension ( HT) is one of the most prevalent chronic diseases in the world, and affects an estimated 77.9 million Americans over 20 years old, of which 78% were aware of their diagnosis, 68 % used antihypertensive medication , but only 64% of the treated patients were controlled. Methods: a systematic search of the scientific literature on the basis of PUBMED , SCIELO and EMBASE data of primary and secondary items with a defined strategy limited to Spanish and English was performed using various combinations of free terms and Mesh type that included: resistant hypertension, secondary high blood pressure, pseudo-resistance and renal sympathetic denervation. Results: resistant hypertension is defined as that which remains outside goals, > 140/90 mmHg in the general population after the use of three antihypertensive agents of different classes at optimal doses being one of them a diuretic. Patients who despite being controlled required the use of four or more drugs were also included. The rate of resistant hypertension has increased in recent years along with obesity and diabetes. The phenomenon is related to secondary causes, pseudo-resistance and sympathetic hyperactivity. Search and control of these factors together with the optimization of medical management are the mainstay of treatment. In patients not adequately controlled despite these measures, the renal sympathetic denervation therapy becomes an effective therapeutic tool. Conclusion: the prevalence of resistant hypertension has increased significantly in the last decade. Optimal medical management and consideration of renal sympathetic denervation therapy becomes the mainstay of treatment. (Acta Med Colomb 2014; 39: 57-63).
Keywords : resistant hypertension; pseudo-resistance; renal denervation therapy.