Why is blood pressure so hard to control in patients with type 2 diabetes?
Why is blood pressure so hard to control in patients with type 2 diabetes?
复制标题
为什么2型糖尿病患者的血压如此难以控制？
DOI：
10.1111/j.1559-4564.2007.06124.x
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
K. Kario
中科院分区：
文献类型：
--
作者：
K. Eguchi;T. Pickering;K. Kario
2型糖尿病合并高血压患者对抗高血压药物的耐药性很常见。这是不幸的，因为高血压是发生心血管事件的最重要的危险因素之一，并且糖尿病受试者的目标血压水平设定为低于非糖尿病受试者。以前在糖尿病受试者中进行的结局试验主要集中在终点，如微量白蛋白尿或心血管事件的发生率，而不是降低血压;然而，一些报告提出了耐药性的机制。这些包括几种已知与降低血压困难相关的临床病症，特别是糖尿病患者：肾素-血管紧张素系统和糜酶的变化、容量超负荷、中枢交感神经功能亢进、睡眠呼吸暂停、继发性高血压、假性阻力（白色高血压）和与亚临床抑郁症相关的依从性差。本文综述了糖尿病高血压患者抗高血压治疗（特别是血管紧张素转换酶抑制剂或血管紧张素II拮抗剂）耐药的机制。
Resistance to antihypertensive drugs is common in hypertensive patients with type 2 diabetes. This is unfortunate because hypertension is one of the most important risk factors for development of cardiovascular events, and the goal blood pressure level is set lower in diabetic subjects than in nondiabetic subjects. Previous outcome trials in diabetic subjects have mainly focused on end points such as microalbuminuria or the incidence of cardiovascular events rather than on reduction of blood pressure; some reports, however, have suggested mechanisms for the drug resistance. These include several clinical conditions known to be associated with difficulty in reducing blood pressure specifically in diabetes mellitus: change in the renin-angiotensin system and chymase, volume overload, central sympathetic hyperactivity, sleep apnea, secondary hypertension, pseudoresistance (white coat hypertension), and poor compliance related to subclinical depression. In this review, the authors focus on the mechanisms of resistance to antihypertensive therapy (particularly for monotherapy with either angiotensin-converting enzyme inhibitors or angiotensin II antagonists) in the treatment of diabetic hypertension.
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DOI：
--
发表时间：
1992
期刊：
The American journal of pathology
影响因子：
--
作者：
G. Wolf;U. Haberstroh;E. Neilson
通讯作者：
G. Wolf;U. Haberstroh;E. Neilson
影响因子：
158.5
作者：
Estacio, RO;Jeffers, BW;Schrier, RW
通讯作者：
Schrier, RW
DOI：
10.1164/rccm.200504-637oc
发表时间：
2005-12-15
影响因子：
24.7
作者：
Reichmuth, KJ;Austin, D;Young, T
通讯作者：
Young, T
适度限制钠盐和各种利尿剂治疗高血压。
影响因子：
--
作者：
Ram,CV;Garrett,BN;Kaplan,NM
通讯作者：
Kaplan,NM