一种治疗顽固性高血压的新方法经导管肾神经消融精选.pptVIP

一种治疗顽固性高血压的新方法:经导管肾神经消融 中国医学科学院阜外心血管病医院 蒋 雄 京 More information Total body and renal spillover noradrenaline were attenuated as was sympathetic nerve activity. BP reductions were significant and maintained at 12 months (-24/-11mmhg n=63) and over 2 years (-33/-15mmHg n=17) no evidence of procedure related renal artery stenosis. There was some early evidence of organ protection. Symplicity HTN-2: Denervation effective for treating resistant hypertension Lancet 2010; Advance online A group of 100 patients who, despite taking three or more antihypertensive drugs, had a baseline systolic BP of ≥160 mm Hg – ≥150 mm Hg for type 2 diabetics – were randomly assigned to  Novel therapeutic targets for hypertensionLudovit Paulis, Thomas UngerNature Reviews Cardiology 7, 431-441 (August 2010) ? Further studies are required to confirm the long-term safety and efficacy of this procedure, particularly the risk of catheter-induced atherosclerotic complications or reinervation, minimally invasive percutaneous ablation of renal nerves has some potential for the treatment of patients with resistant hypertension. * * Background ? Hypertension is a global public health problem of major magnitude ? An estimated 30-40% of the adult population in the developed world suffers from this condition. ? Despite numerous safe and effective pharmacological therapies, only~50% of patients achieve blood pressure control to guideline targets ? Renal sympathetic efferent and afferent nerves, which lie in the wall of the renal artery, have been recognized as seminal in the initiation and maintenance of systemic hypertension Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275– p0.0001?? 33/11 mm Hg? 1/0 mm Hg? 32/12 mm Hg Primary endpointReduction in BP at 6 months?? p value Between-group difference?? Usual care(n=51)? Renal denervation group(n=49)? ? This