Sistemik Hipertansiyonun Güncel Tanı ve Tedavisi

Hipertansiyon; iki ya da daha fazla sayıda uygun ?artlarda yapılmı? kan basıncı ölçümünün 140/90 mmHg veya daha yüksek olması olarak tanımlanmaktadır. Avrupa Kardiyoloji ve Avrupa Hipertansiyon Derneklerinin (European Society of Hypertension/European Society of Cardiology (ESC/ESH) 2013 kılavuzunda önerilen hipertansiyon sınıflandırması Tablo 1'de verilmi?tir3. Dünya Sağlık Örgütü verilerine göre hipertansiyon prevelansı %20 ile %50 arası deği?mektedir4. TURDEP2 çalı?masına göre Türkiye'deki prevalansı ise %31.3 bulunmu?tur5. Dünya nüfusunun giderek ya?lanması, obez birey sayısının artı?ı nedeniyle 2025 yılında dünya

Current Diagnosis and Treatment of Systemic Hypertension

Hypertension remains one of the most important medical problems despite significant medical advances in recent years. Many observational studies showed a continuous relationship with cardiovascular morbidity and mortality in both systolic and diastolic blood pressure. World Health Organization reports that high blood pressure is the leading cause of death worldwide. Since it will also be an important public health problem in the future as it is now, the need for developing new guidelines based on new studies emerges. In this article, the current diagnosis and treatment of hypertension has been briefly reviewed. Key words: Hypertension, blood pressure, cardiovascular system.

PDF

___

1. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Age specific relevance of usual blood pressure to vascular mortality: a metaanalysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:190313.
2. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002;360:134760.
3. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M et al. Task Force for the Management of Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology.2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Blood Press. 2014;23:316.
4. WolfMaier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289:23639.
5. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N et al. TURDEPII Study Group. Twelveyear trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol.2013;28:16980.
6. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002;360:1347–60.
7. World Health Report. Reducing risks, promoting healthy life. Geneva (Switzerland): World Health Organization; 2002.
8. Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16:1426.
9. Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Compbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and metaanalysis. Lancet. 2012;379:905–14.
10. Fagard RH, De Cort P. Orthostatic hypotension is a more robust predictor of cardiovascular events than nighttime reverse dipping in elderly. Hypertension.2010;56: 56–61.
11. Mancia G, Omboni S, Parati G, Trazzi S, Mutti E. Limited reproducibility of hourly blood pressure values obtained by ambulatory blood pressure monitoring: implications for studies on antihypertensive drugs. J Hypertens. 1992;10:1531–5.
12. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y et al. European Society of Hypertension practice guidelines for home blood pressure monitoring. J Hum Hypertens. 2010;24:779–85.
13. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Yet al. European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008;26:1505–26.
14. Fagard RH, Cornelissen VA. Incidence of cardiovascular events in whitecoat, masked and sustained hypertension vs. true normotension: a metaanalysis. J Hypertens. 2007;25:2193–8.
15. Mancia G, Bombelli M, Facchetti R, Madotto F, QuartiTrevano F, Polo Friz H et al. Longterm risk of sustained hypertension in whitecoat or masked hypertension. Hypertension 2009;54:226–32.
16. Bobrie G, Clerson P, Menard J, PostelVinay N, Chatellier G, Plouin PF. Masked hypertension: a systematic review. J Hypertens. 2008;26:1715–25.
17. Pierdomenico SD, Cuccurullo F. Prognostic value of whitecoat and masked hypertension diagnosed by ambulatory monitoring in initially untreated subjects: an updated meta analysis. Am J Hypertens.2011;24:52–8.
18. James PA, Oparil S, Carter BL, Cushman WC, DennisonHimmelfarb C, Handler J et al. 2014 evidencebased guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC8). JAMA.2014;311:507 20.
19. Seravalle G, Lonati L, Buzzi S, Cairo M, Quarti Trevano F, Dell'Oro R et al. Sympathetic nerve traffic and baroreflex function in optimal, normal, and highnormal blood pressure states. J Hypertens. 2015;33:14117.
20. Ott C, Schmieder RE. Renal denervation for resistant hypertension: past, present, and future. Curr Hypertens Rep.2015;17:577.
21. Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Böhm M. Renal sympathetic denervation in patients with treatmentresistant hypertension (The Symplicity HTN2 Trial): a randomised controlled trial. Lancet. 2010;376:1903–9.
22. Bisognano JD, Bakris G, Nadim MK, Sanchez L, Kroon AA, Schafer J et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the doubleblind, randomized, placebocontrolled rheos pivotal trial. J Am Coll Cardiol. 2011;58:765–73.