Điều trị Tăng huyết áp ở bệnh nhân Rối loạn chức năng tâm thất trái: Nhắm đúng mục tiêu và Tránh xa khó khăn

Springer Science and Business Media LLC - Tập 10 - Trang 157-164 - 2013
Samuel W. Joffe1, Robert A. Phillips1,2
1University of Massachusetts Medical School, Worcester, USA
2Heart and Vascular Center of Excellence, UMass Memorial Medical Center, Worcester, USA

Tóm tắt

Tăng huyết áp là một yếu tố nguy cơ hàng đầu trong sự phát triển của suy tim (HF), tuy nhiên các hướng dẫn hiện tại không xác định bậc huyết áp (BP) mục tiêu cho bệnh nhân có rối loạn chức năng tâm thất trái (LV) đã được xác lập. Mặc dù chưa có thử nghiệm lâm sàng ngẫu nhiên (RCT) nào được tiến hành để xác định huyết áp tối ưu cho những bệnh nhân này, nhiều thử nghiệm đã chứng minh lợi ích của một số nhóm thuốc và các chiến lược điều trị ở bệnh nhân bị HF. Các yếu tố quan trọng cần xem xét trong việc điều trị tăng huyết áp ở bệnh nhân mắc suy tim bao gồm loại HF (giảm phân suất tống máu so với bảo tồn phân suất tống máu), nguyên nhân (thiếu máu cục bộ so với không thiếu máu cục bộ), mức độ triệu chứng nếu có, huyết áp cơ bản, cũng như nhiều yếu tố đặc thù của từng bệnh nhân. Bài báo này xem xét các bằng chứng hiện tại để giải quyết câu hỏi: "Mục tiêu huyết áp cho bệnh nhân có rối loạn chức năng tâm thất trái không triệu chứng và có triệu chứng nên là gì?" Chúng tôi đề xuất một mức huyết áp mục tiêu là 120–140/70–90 mm Hg trong hầu hết các trường hợp, với huyết áp thấp hơn thường là lựa chọn tốt hơn nếu bệnh nhân có thể chịu đựng.

Từ khóa

#tăng huyết áp #suy tim #rối loạn chức năng tâm thất trái #huyết áp mục tiêu

Tài liệu tham khảo

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