一种治疗顽固性高血压的新方法经导管肾神经消融蒋雄京.ppt

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, only50% 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,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,This procedure provides a revolutionary, non-drug method for controlling high blood pressure in patients who are unresponsive to multiple antihypertensive drugs,Novel therapeutic targets for hypertension Ludovit Paulis, Thomas Unger Nature 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 re