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Renaliz-67
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KANITLAR ANTİHİPERTANSİF TEDAVİYİ ETKİLEYECEK KADAR GÜÇLÜ MÜ?
s E <ĂƌĚŝLJŽƌĞŶĂů ^ƺƌĞĕƚĞ Z ^ ůŽŬĂũŦ dĞĚĂǀŝƐŝ
(Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation)
,ĂƐƚĂůŦŬ ǀĞ ŝƌŝŶĐŝů ^ŽŶůĂŶŦŵ 7 Z MRA
<ĂůƉ LJĞƚĞƌƐŝnjůŝŒŝŶĚĞ Ƃůƺŵ 9 9 9
DĂũƂƌ DĂŬƌŽǀĂƐŬƺůĞƌ ǀĞ dƺŵ EĞĚĞŶůĞƌĞ ĂŒůŦ DŝLJŽŬĂƌĚ ŝŶĨĂƌŬƚƺƐƺ ƐŽŶƌĂƐŦŶĚĂ Ƃůƺŵ 9 9 9
DŝŬƌŽǀĂƐŬƺůĞƌ KůĂLJůĂƌ Půƺŵ <s ƌŝƐŬŝ LJƺŬƐĞŬ ŽůĂŶ ŚĂƐƚĂůĂƌĚĂ Ƃůƺŵ 9 9
7ŶŵĞ 9 9
dĞŬƌĂƌůĂLJĂŶ ŝŶŵĞ 9 9
dŝƉ Ϯ ĚŝLJĂďĞƚŝŬ ŚĂƐƚĂůĂƌĚĂ Ƃůƺŵ 9
ŝLJĂďĞƚ ĚŦƔŦ KBY’de ƌĞŶĂů ƐŽŶůĂŶŦŵ 9
dŝƉ ϭ ĚŝLJĂďĞƚĞ ďĂŒůŦ ŶĞĨƌŽƉĂƚŝĚĞ ƌĞŶĂů 9
ƐŽŶůĂŶŦŵ
dŝƉ Ϯ ŝLJĂďĞƚƚĞ 'ĞƌĕĞŬůĞƔƚŝƌŝůĞŶ dŝƉ Ϯ ĚŝLJĂďĞƚĞ ďĂŒůŦ ŶĞĨƌŽƉĂƚŝĚĞ ƌĞŶĂů 9
ƐŽŶůĂŶŦŵ
Ŷ ƺLJƺŬ DŽƌďŝĚŝƚĞ-DŽƌƚĂůŝƚĞ ĂůŦƔŵĂƐŦ dŝƉ ϭ ĚŝLJĂďĞƚĞ ďĂŒůŦ ůĂƚĞŶƚ ŶĞĨƌŽƉĂƚŝĚĞ ĂƔŝŬĂƌ 9 9
ŶĞĨƌŽƉĂƚŝ ŐĞůŝƔŝŵŝ
dŝƉ Ϯ ĚŝLJĂďĞƚƚĞ ŵŝŬƌŽĂůďƺŵŝŶƺƌŝ ŐĞůŝƔŝŵŝ 9 9
KDW>/^,
(Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension) 2011
KƌƚĂůĂŵĂ ϯϲ ĂLJůŦŬ ďŝƌ ƚĂŬŝƉ ƐŽŶƌĂƐŦŶĚĂ͕
ĕĂůŦƔŵĂ ĞƌŬĞŶ ŽůĂƌĂŬ ƐŽŶůĂŶĚŦƌŦůĚŦ ͊
%20
,ŝƉĞƌƚĂŶƐŝLJŽŶƵ ŽůĂŶ ǀĞ <s ŽůĂLJ ƌŝƐŬŝ LJƺŬƐĞŬ ŽůĂŶ ϭϭ͕ϱϬϲ ŚĂƐƚĂ
P<0.001
¾DŝLJŽŬĂƌĚ ŝŶĨĂƌŬƚƺƐƺ͕ ƌĞǀĂƐŬƺůĂƌŝnjĂƐLJŽŶ ǀĞLJĂ ŝŶŵĞ
ŚŝŬĂLJĞƐŝ
¾ ƂďƌĞŬ ĨŽŶŬƐŝLJŽŶ ďŽnjƵŬůƵŒƵ
¾Periferik ĂƌƚĞƌ ŚĂƐƚĂůŦŒŦ
¾^Žů ǀĞŶƚƌŝŬƺů ŚŝƉĞƌƚƌŽĨŝƐŝ
¾ ŝĂďĞƚĞƐ ŵĞůůŝƚƵƐ
Jamerson K et al: N Engl J Med 359: 2417 2428 2008
2013 ESH/ESC Guidelines for the Management of Arterial Hypertension ^WZ/Ed ^WZ/Ed
(Systolic Blood Pressure Intervention Trial) (Systolic Blood Pressure Intervention Trial)
ŶƚŝŚŝƉĞƌƚĂŶƐŝĨ 7ůĂĕ <ŽŵďŝŶĂƐLJŽŶůĂƌŦ
ͻ ŽŬ ŵĞƌŬĞnjůŝ͕ ƌĂŶĚŽŵŝnjĞ͕ ŬŽŶƚƌŽůůƺ͕ ĂĕŦŬ ĞƚŝŬĞƚůŝ
ĕĂůŦƔŵĂ
dŝLJĂnjŝĚ ĚŝƺƌĞƚŝŬůĞƌ ͻ ŵĞƌŝŬĂ ŝƌůĞƔŝŬ ĞǀůĞƚůĞƌŝ͛ŶĚĞŬŝ ϭϬϮ ŵĞƌŬĞnj
ͻ ^ŝƐƚŽůŝŬ ŬĂŶ ďĂƐŦŶĐŦ ;^< Ϳ х ϭϯϬ ŵŵ ,Ő ŽůĂŶ͕
LJƺŬƐĞŬ ŬĂƌĚŝLJŽǀĂƐŬƺůĞƌ ƌŝƐŬŝ ŽůĂŶΎ ĨĂŬĂƚ ĚŝLJĂďĞƚŝ
ŽůŵĂLJĂŶ ϵϯϲϭ ŚĂƐƚĂ
ĞƚĂ ďůŽŬĞƌůĞƌ ŶũŝLJŽƚĞŶƐŝŶ ƌĞƐĞƉƚƂƌ ͻ ,ĂƐƚĂůĂƌ LJŽŒƵŶ ƚĞĚĂǀŝ ;^< ф ϭϮϬ ŵŵ ,ŐͿ ǀĞLJĂ
ďůŽŬĞƌůĞƌŝ
ƐƚĂŶĚĂƌƚ ƚĞĚĂǀŝ ;^< ф ϭϯϬ ŵŵ ,ŐͿ ŐƌƵƉůĂƌŦŶĂ
ƌĂŶĚŽŵŝnjĞ ĞĚŝůĚŝůĞƌ͘
ͻ ŝƌŝŶĐŝů ďŝƌůĞƔŝŬ ƐŽŶůĂŶŦŵ ŶŽŬƚĂƐŦ͗ DŝLJŽŬĂƌĚ
ŝŶĨĂƌŬƚƺƐƺ͕ ĚŝŒĞƌ ĂŬƵƚ ŬŽƌŽŶĞƌ ƐĞŶĚƌŽŵůĂƌ͕
ŝŶŵĞ͕ ŬĂůƉ LJĞƚĞƌƐŝnjůŝŒŝ ǀĞLJĂ <s ŶĞĚĞŶůĞƌĞ ďĂŒůŦ
ŝŒĞƌ <ĂůƐŝLJƵŵ
ĂŶƚŝŚŝƉĞƌƚĂŶƐŝĨůĞƌ ĂŶƚĂŐŽŶŝƐƚůĞƌŝ Ƃůƺŵ
Ύ7ŶŵĞ ĚŦƔŦŶĚĂ ŬůŝŶŝŬ ǀĞLJĂ subklinik <s ŚĂƐƚĂůŦŬ͖ eGFR’nin
20 – 60 ml/dak/1.73 m 2 ŽůĚƵŒƵ < , ;polikistik böbrek
ŚĂƐƚĂůŦŒŦ ĚŦƔŦŶĚĂͿ͕ Framingham risk ƐŬŽƌůĂŵĂƐŦŶĂ göre 10 ŝƌŝŶĐŝů ŝƌůĞƔŝŬ ^ŽŶůĂŶŦŵ EŽŬƚĂƐŦ: Miyokard infarktüsü͕ ĚŝŒĞƌ ĂŬƵƚ ŬŽƌŽŶĞƌ ƐĞŶĚƌŽŵůĂƌ͕ ŝŶŵĞ͕
LJŦůůŦŬ <s ƌŝƐŬŝŶ > йϭϱ ŽůŵĂƐŦ͖ х ϳϱ LJĂƔ ŬĂůƉ LJĞƚĞƌƐŝnjůŝŒŝ ǀĞLJĂ kardiyovasküler ŶĞĚĞŶůĞƌĞ ďĂŒůŦ Ƃůƺŵ
ŝŶŚŝďŝƚƂƌůĞƌŝ The SPRINT Research Group: N Engl J Med 2015; 373: 2103-2116
The SPRINT Research Group: N Engl J Med 2015; 373: 2103-2116
zĞƔŝů ŬŽLJƵ ĕŝnjŐŝůĞƌ͗ dĞƌĐŝŚ ĞĚŝůĞŶ ŬŽŵďŝŶĂƐLJŽŶůĂƌ͖ zĞƔŝů ŬĞƐŝŬ ĕŝnjŐŝ͗ ĂnjŦ ƐŦŶŦƌůĂŵĂůĂƌ ŽůŵĂŬůĂ ďŝƌůŝŬƚĞ LJĂƌĂƌůŦ ŬŽŵďŝŶĂƐLJŽŶ ͖
^WZ/Ed 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and
Management of High Blood Pressure in Adults
(Systolic Blood Pressure Intervention Trial)
The SPRINT Research Group: N Engl J Med 2015; 373: 2103-2116
2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and
Management of High Blood Pressure in Adults
European Heart Journal 39: 3021-3104, 2018 European Heart Journal 39: 3021-3104, 2018
<ĂŶŦƚůĂƌ ŶƚŝŚŝƉĞƌƚĂŶƐŝĨ dĞĚĂǀŝLJŝ
ƚŬŝůĞLJĞĐĞŬ <ĂĚĂƌ 'ƺĕůƺ ŵƺ͍
ͻ PnjĞů ŚĂƐƚĂ ŐƌƵƉůĂƌŦŶĚĂŬŝ ŝůĂĕ ƐĞĕŝŵŝ
ŬŽŶƵƐƵŶĚĂ LJĞƚĞƌŝŶĐĞ Őƺĕůƺ
ͻ <ĂŶ ďĂƐŦŶĐŦ ŚĞĚĞĨůĞƌŝŶŝ ďĞůŝƌůĞŵĞ
ŬŽŶƵƐƵŶĚĂ LJĞƚĞƌŝŶĐĞ Őƺĕůƺ ĚĞŒŝů͘
ŝƌĂnj ĚĂ ŬĂĨĂ ŬĂƌŦƔƚŦƌŦĐŦ͘
European Heart Journal 39: 3021-3104, 2018
European Heart Journal 39: 3021-3104, 2018
www.anadolubv.org.tr Gelişi Güzel İlaç Kullanarak Gözlerinizi Bozmayın - ABV
