Consensus of Chinese Specialists on Diagnosis and Treatment of Resistant Hypertension

Sun, Ning; Huo, Yong; Wang, Ji‐Guang; Li, Nanfang; Tao, Jun; Li, Yong; Yan, Xiaowei; Jiang, Xiongjing; Li, Xuewang

doi:10.4103/0366-6999.161395

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…Therefore, blocking the renal sympathetic nerve and affecting activation can effectively control blood pressure [13,14]. Expert consensus on the diagnosis and treatment of resistant hypertension in China has noted that patients with uncontrolled essential hypertension despite treatment with four or more antihypertensive drugs (poor treatment adherence) and a high cardiovascular risk may be considered for RDN treatment if they meet the inclusion criteria for RDN [15]. RDN is a minimally invasive technique using an ablation catheter passed via the femoral artery to the bilateral renal arteries to release radiofrequency currents in selected areas to locally heat the renal artery adventitia and block renal sympathetic nerve activity [16], which in turn reduces blood pressure levels.…”

Section: Discussionmentioning

confidence: 99%

Comparison of a 5 F Microtube-Irrigated Ablation Catheter and a General Ablation Catheter in the Treatment of Resistant Hypertension with Renal Denervation

Liu

2021

CVIA

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Objective: To assess the effectiveness of catheter-based renal denervation for reducing blood pressure in patients withresistant hypertension using a 5 F microtube-irrigated ablation catheter.Methods: Sixty patients with resistant hypertension were divided into two groups: a microtube-irrigated ablation catheter group and a general ablation catheter group. We conducted 12-month follow-up of all patients and recorded clinical blood pressure, ambulatory blood pressure, medication use, and biochemistry test results in both groups at the baseline and at the 12-month follow-up.Results: All patients underwent renal denervation. At the 6-month follow-up, ambulatory blood pressure in the microtube-irrigated ablation catheter group was significantly lower than in the general ablation catheter group (systolic blood pressure 142.0 ± 14.4 mmHg vs. 150.8 ± 17.9 mmHg, P = 0.04; diastolic blood pressure 81.2 ± 7.0 mmHg vs. 87.6 ± 8.0 mmHg, P = 0.002). At the 12-month follow-up, the between-group difference in ambulatory blood pressure was not statistically significant. At the 12-month follow-up, the number of antihypertensive drugs and diuretics used in the microtube-irrigated ablation catheter group was less than in the general ablation catheter group (P = 0.043). There was no statistical difference between the two groups in the results of biochemistry tests and echocardiography.Conclusion: The microtube-irrigated ablation catheter is more effective in treating hypertension than the generalablation catheter at the 6-month follow up and thus fewer antihypertensive drugs were used in the microtube-irrigatedablation catheter group than in the general ablation catheter group.

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Section: Discussionmentioning

confidence: 99%

Comparison of a 5 F Microtube-Irrigated Ablation Catheter and a General Ablation Catheter in the Treatment of Resistant Hypertension with Renal Denervation

Liu

2021

CVIA

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“…Resistant hypertension is common, and often has secondary causes of hypertension. In fact, one of the aims to define resistant hypertension was to identify and treat secondary causes of hypertension (18,19). The recent 2017 American hypertension guidelines recommended screen for various secondary causes of hypertension in resistant hypertension (20).…”

Section: Primary Aldosteronism Screen In Resistant Hypertensionmentioning

confidence: 99%

“…There is guideline and consensus on the diagnosis and treatment of primary aldosteronism (21,22). In China, however, the situation is that endocrinologists have the expertise of primary aldosteronism (23), but cardiologists manage hypertension, including resistant hypertension (19). Few Chinese cardiologists have sufficient awareness and knowledge to do primary aldosteronism screen.…”

Section: Primary Aldosteronism Screen In Resistant Hypertensionmentioning

confidence: 99%

Unique approaches to hypertension control in China

Wang¹

2018

Ann. Transl. Med.

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According to the China nationwide hypertension survey in 2012-2015, the prevalence of hypertension in adults (≥18 years) was 27.9%, which increased approximately by 50% from 2002 (18.8%). The management of hypertension was improved, but still at low level, with the awareness, treatment and control rates of 46.9%, 40.7% and 15.3%, respectively. The challenge was still the low awareness and the low control rate in treated hypertension (37.5%). Several actions are currently being taken to improve hypertension control in China. In collaboration with the International Society of Hypertension May Measurement Month (MMM) Program, hundreds of volunteers across the country measured blood pressure in a large number of people in summer since 2017. In addition, a nationwide Web-based and WeChat-linked blood pressure measurement system is being built, with thousands of devices installed in public places within easy-reach of people. To improve blood pressure control in treated hypertension, two initiatives are being undertaken. One is the expanding use of ambulatory blood pressure monitoring to guide antihypertensive treatment. Another is primary aldosteronism screen in resistant hypertension. It is hoped that in the framework of the Healthy China 2030 Program the control rate of hypertension may increase in the next 10 years to 50% or higher by increasing both the awareness rate in the population and control rate in treated hypertensive patients to 70% or higher.

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“…In treated hypertensive participants, the rate of blood pressure reaching standard is 27.4%. [ 1 ] In clinical practice, essential hypertension (EH) cannot be effectively controlled, leading to the specific target organ damage (TOD) such as heart disease, cerebrovascular disease, vascular dementia, renal failure, atherosclerotic vascular disease, and retinopathy[ 2 ] TOD caused by EH is a complex process involving biochemistry, inflammations, and hemodynamics. [ 3 ] It is found that atherosclerosis (AS) is the pathogenesis of the occurrence of different TOD in EH, and the inflammation hypothesis is also considered as the main mechanism of AS.…”

Section: Introductionmentioning

confidence: 99%

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients

Lai

Xing

Liu

et al. 2017

Chinese Medical Journal

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Background:Atherosclerosis (AS) is an inflammatory disease. Inflammation was considered to play a role in the whole process of AS. This study aimed to analyze the relationships of inflammatory factors and risk factors with different target organ damages (TOD) in essential hypertension (EH) patients and to explore its clinical significance.Methods:A total of 294 EH patients were selected and divided into four groups according to their conditions of TOD. Forty-eight healthy subjects were selected as control. The clinical biochemical parameters, serum amyloid A, serum tryptase, and lipoprotein-associated phospholipase A2 (Lp-PLA2) in each group were detected, and the related risk factors were also statistically analyzed.Results:Fibrinogen (Fbg) was the most significant independent risk factor in acute coronary syndrome (ACS) group (odds ratio [OR]: 22.242, 95% confidence interval [CI]: 6.458–76.609, P < 0.001) with the largest absolute value of the standardized partial regression coefficient B’ (b’: 1.079). Lp-PLA2 was the most significant independent risk factor in stroke group (OR: 13.699, 95% CI: 5.236–35.837, P < 0.001) with b’ = 0.708. Uric acid (UA) was the most significant independent risk factor in renal damage group (OR: 15.307, 95% CI: 4.022–58.250, P < 0.001) with b’ = 1.026.Conclusions:Fbg, Lp-PLA2, and UA are the strongest independent risk factors toward the occurrence of ACS, ischemic stroke, and renal damage in EH patients, thus exhibiting the greatest impacts on the occurrence of ACS, ischemic stroke, and renal damage in EH patients, respectively.

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Consensus of Chinese Specialists on Diagnosis and Treatment of Resistant Hypertension

Cited by 8 publications

References 25 publications

Comparison of a 5 F Microtube-Irrigated Ablation Catheter and a General Ablation Catheter in the Treatment of Resistant Hypertension with Renal Denervation

Comparison of a 5 F Microtube-Irrigated Ablation Catheter and a General Ablation Catheter in the Treatment of Resistant Hypertension with Renal Denervation

Unique approaches to hypertension control in China

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients

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