A Simplified Mechanistic Algorithm for Treating Resistant Hypertension: Efficacy in a Retrospective Study

作者:Mann Samuel J*; Parikh Neal S
来源:Journal of Clinical Hypertension, 2012, 14(4): 191-197.
DOI:10.1111/j.1751-7176.2012.00605.x

摘要

This retrospective study assessed the efficacy of a recently described, mechanism-based algorithm for treating resistant hypertension. Charts of consecutive patients seen for resistant hypertension were reviewed. Algorithm-based intervention was limited to either or both of just 2 options: (1) strengthening of the diuretic regimen, usually with addition of spironolactone; and (2) treatment with the combination of an alpha-+ nonmetabolized beta-blocker. Of 27 patients, 24 (89%) achieved control, including 13 (54%) in whom the diuretic regimen was strengthened, 6 (25%) in whom alpha-/beta-blockade was instituted, and 5 (21%) who received both interventions. The most frequent medication adjustments were addition of a potassium-sparing diuretic in 16 (67%), doxazosin in 9 (37.5%), and replacing a metabolized with a nonmetabolized beta-blocker in 6 (25%). The authors conclude that treatment based on this algorithm can both simplify and improve the management of resistant hypertension and merits further evaluation in prospective studies. J Clin Hypertens (Greenwich). 2012;14:191-197.

  • 出版日期2012-4