{"id":2758,"date":"2023-02-09T20:57:04","date_gmt":"2023-02-09T20:57:04","guid":{"rendered":"https:\/\/www.karotidnahirurgija.com\/?page_id=2758"},"modified":"2023-02-24T12:30:42","modified_gmt":"2023-02-24T12:30:42","slug":"7-3-antihipertenzivna-terapija","status":"publish","type":"page","link":"https:\/\/www.karotidnahirurgija.com\/?page_id=2758","title":{"rendered":"7.3. ANTIHIPERTENZIVNA TERAPIJA"},"content":{"rendered":"

\"\"<\/a><\/p>\n

<\/p>\n

MEDIKAMENTOZNA TERAPIJA KAROTIDNE BOLESTI<\/h1>\n

<\/a><\/h1>\n

\n

\n

7.3. ANTIHIPERTENZIVNA TERAPIJA<\/p>\n

<\/h3>\n<\/div>\n
\n

Antihipertenzivna terapija<\/h3>\n

Prema preporukama ESH-ESC (European<\/i> <\/i>Society<\/i> <\/i>for<\/i> <\/i>Hypertension<\/i>), terapija hipertenzije je osnovno na\u010delo kontrole kardiovaskularnih faktora rizika i preporu\u010dene vrednosti odr\u017eavanja arterijskog pritiska za pacijente koji nemaju \u0161e\u0107ernu bolest su manje od 140\/90 mmHg, odnosno manje od 130\/90 mmHg kod dijabeti\u010dara.<\/p>\n

Novi antihipertenzivni lekovi, pored redukcije povi\u0161enog krvnog pritiska, imaju i druga korisna dejstva, kao \u0161to je antiinflamatorno. Prema rezultatima HOPE studije dozom od 5mg Ramiprila dnevno se posti\u017ee zna\u010dajna redukcija rizika od kasnih ishemijskih komplikacija, a kasnije je dokazano da najve\u0107i klini\u010dki benefit od terapije Ramiprilom imaju pacijenti sa perifernom okluzivnom bole\u0161\u0107u.<\/p>\n

Losarntan (selektivni blokator AT1 receptora) posti\u017ee ve\u0107i benefit u prevenciji ishemijskih komplikacija, nego beta-blokeri, a pri tom je podjednako efikasan u kontroli hipertenzije.<\/p>\n

Diabetes mellitus<\/h3>\n

Preporuke za kontrolu dijabetesa iznose da istovremenom kontrolom faktora rizika,<\/span> <\/span>dijabetesa<\/span> <\/span>i<\/span> <\/span>hipertenzije<\/span> <\/span>mo\u017eemo<\/span> <\/span>dugoro\u010dni<\/span> <\/span>rizik<\/span> <\/span>od<\/span> <\/span>mo\u017edanog<\/span> <\/span>udara<\/span> <\/span>smanjiti<\/span> <\/span>za<\/span> <\/span>40%.<\/span><\/p>\n

Modi<\/b><\/span>fi<\/b><\/span>kacija<\/b><\/span> <\/b><\/span>\u017eivotnih<\/b><\/span> <\/b><\/span>navika<\/b><\/span><\/p>\n

Pu\u0161enje,<\/span> <\/span>fi<\/span>zi\u010dka<\/span> <\/span>neaktivnost<\/span> <\/span>i<\/span> <\/span>gojaznost<\/span> <\/span>su<\/span> <\/span>va\u017eni<\/span> <\/span>faktori<\/span> <\/span>rizika<\/span> <\/span>za<\/span> <\/span>razvoj<\/span> <\/span>karotidne<\/span> <\/span>bolesti.<\/span> <\/span>Modi<\/span>fi<\/span>kacija<\/span> <\/span>ovih<\/span> <\/span>faktora<\/span> <\/span>je<\/span> <\/span>va\u017ena<\/span> <\/span>u<\/span> <\/span>prevenciji<\/span> <\/span>mo\u017edanog<\/span> <\/span>udara<\/span> <\/span>u<\/span> <\/span>pacijenata<\/span> <\/span>sa<\/span> <\/span>karotidnom<\/span> <\/span>stenozom.<\/span> <\/span>Potkomitet<\/span> <\/span>za<\/span> <\/span>faktore<\/span> <\/span>rizika<\/span> <\/span>i<\/span> <\/span>\u0161log <\/span>Saveta<\/span> <\/span>ameri\u010dkog<\/span> <\/span>udru\u017eenja<\/span> <\/span>za<\/span> <\/span>srce<\/span> <\/span>(<\/span>Subcommittee<\/i><\/span> <\/i><\/span>on<\/i><\/span> <\/i><\/span>Risk<\/i><\/span> <\/i><\/span>Factors<\/i><\/span> <\/i><\/span>and<\/i><\/span> <\/i><\/span>Stroke<\/i><\/span> <\/i><\/span>of<\/i><\/span> <\/i><\/span>the<\/i><\/span> <\/i><\/span>Stroke<\/i><\/span> <\/i><\/span>Council<\/i><\/span> <\/i><\/span>of<\/i><\/span> <\/i><\/span>the<\/i><\/span> <\/i><\/span>American<\/i><\/span> <\/i><\/span>Heart<\/i><\/span> <\/i><\/span>Association<\/i><\/span>)<\/span> <\/span>podelio<\/span> <\/span>je<\/span> <\/span>faktore<\/span> <\/span>rizika<\/span> <\/span>na<\/span> <\/span>dokazane<\/b><\/span> <\/b><\/span>(TIA,<\/span> <\/span>\u0161um<\/span> <\/span>nad<\/span> <\/span>karotidnom<\/span> <\/span>arterijom,<\/span> <\/span>hipertenzija,<\/span> <\/span>sr\u010dane<\/span> <\/span>bolesti,<\/span> <\/span>pu\u0161enje,<\/span> <\/span> <\/span>povi\u0161en<\/span> <\/span>hematokrit,<\/span> <\/span>bolest<\/span> <\/span> <\/span>srpastih<\/span> <\/span> <\/span>\u0107elija,<\/span> <\/span> <\/span>hematolo\u0161ki<\/span> <\/span> <\/span>faktori, <\/span>hiperkoagulabilnost<\/span> <\/span>krvi)<\/span> <\/span>i <\/span>nedokazane<\/b><\/span> <\/b><\/span>(gojaznost,<\/span> <\/span>alkoholizam,<\/span> <\/span>neaktivnost,<\/span> <\/span>hiperurikemija,<\/span> <\/span>in<\/span>fl<\/span>amator-<\/span> <\/span>ne<\/span> <\/span>bolesti,<\/span> <\/span>etni\u010dka<\/span> <\/span>pripadnst,<\/span> <\/span>stres<\/span> <\/span>itd.),<\/span> <\/span>i<\/span> <\/span>kao<\/span> <\/span>na<\/span> <\/span>one <\/span>na<\/b><\/span> <\/b><\/span>koje<\/b><\/span> <\/b><\/span>mo\u017eemo<\/b><\/span> <\/b><\/span>uticati<\/b><\/span> <\/b><\/span>(tip<\/span> <\/span>ishrane,<\/span> <\/span>hipertenzija,<\/span> <\/span>dijabetes<\/span> <\/span>melitus,<\/span> <\/span>pu\u0161enje,<\/span> <\/span>hiperholesterolemija,<\/span> <\/span>hiperlipemija,<\/span> <\/span>oralna<\/span> <\/span>kontraceptivna<\/span> <\/span>sredstva<\/span> <\/span>socio-<\/span> <\/span>ekonomski<\/span> <\/span>faktori,<\/span> <\/span>pasivan<\/span> <\/span>na\u010din<\/span> <\/span>\u017eivota,<\/span> <\/span>familijarna<\/span> <\/span>predispozicija),<\/span> <\/span>za<\/span> <\/span>razliku<\/span> <\/span>od<\/span> <\/span>onih <\/span>na<\/b><\/span> <\/b><\/span>koje<\/b><\/span> <\/b><\/span>ne<\/b><\/span> <\/b><\/span>mo\u017eemo<\/b><\/span> <\/b><\/span>uticati<\/b><\/span> <\/b><\/span>(starost<\/span> <\/span>i<\/span> <\/span>genetski<\/span> <\/span>faktori,<\/span> <\/span>raniji<\/span> <\/span>mo\u017edani<\/span> <\/span>udar,<\/span> <\/span>klimatski<\/span> <\/span>faktori).<\/span><\/p>\n<\/div>\n


\n<\/p>\n","protected":false},"excerpt":{"rendered":"

MEDIKAMENTOZNA TERAPIJA KAROTIDNE BOLESTI 7.3. ANTIHIPERTENZIVNA TERAPIJA Antihipertenzivna terapija Prema preporukama ESH-ESC (European Society for Hypertension), terapija hipertenzije je osnovno na\u010delo kontrole kardiovaskularnih faktora rizika i preporu\u010dene vrednosti odr\u017eavanja arterijskog pritiska za pacijente koji nemaju \u0161e\u0107ernu bolest su manje od 140\/90 mmHg, odnosno manje od 130\/90 mmHg kod dijabeti\u010dara. Novi antihipertenzivni lekovi, pored redukcije povi\u0161enog […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2758","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\n7.3. 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