高血压是心脑血管疾病的主要危险因素之一,会增加心衰、脑卒中、冠心病等疾病的发生风险。难治性高血压是高血压的一种特殊类型,对于常规降压方案无效或不敏感。该类患者由于血压长期不达标,其心血管事件发生风险远高于一般高血压患者。在终末期肾病患者中由于液体潴留、动脉僵硬度增加、肾脏代谢异常等因素,难治性高血压发生率相对较高。然而目前关于该类患者高血压发生或进展的致病机制尚不明确且常规降压治疗效果欠佳。本文就终末期肾病患者难治性高血压致病机制及治疗策略作简要阐述。Hypertension is one of the main risk factors of cardiovascular and cerebrovascular diseases, which will increase the risk of heart failure, stroke, coronary heart disease and other diseases. Treatment-resistant hypertension is a specific type of high blood pressure that is ineffective or insensitive to conventional blood pressure lowering regiments. Due to long-term substandard blood pressure, the risk of cardiovascular events in these patients is much higher than that in general hypertensive patients. The incidence of refractory hypertension is relatively high in patients with end-stage renal disease due to fluid retention, increased arterial stiffness and abnormal renal metabolism. However, the pathogenesis of hypertension in these patients is still unclear and the effect of conventional antihypertensive therapy is not good. In this paper, the pathogenesis and treatment strategies of refractory hypertension in patients with end-stage renal disease were briefly reviewed.
