替尔泊肽：顽固性高血压治疗迎来新契机？一则成功个案引爆讨论

Core Viewpoint - The article discusses the challenges and new perspectives in the treatment of resistant hypertension, highlighting the potential of GLP-1/GIP receptor agonists in managing blood pressure for patients who do not respond to traditional medications [6][12]. Group 1: Resistant Hypertension - Resistant hypertension is defined as a condition where patients cannot achieve effective blood pressure control despite using five or more antihypertensive medications at maximum doses [6]. - This condition significantly increases the risk of cardiovascular and renal complications, yet treatment options remain limited [6]. Group 2: Case Study and Treatment Progress - A case study of a 71-year-old female patient illustrates the challenges of managing resistant hypertension. Despite being on eight antihypertensive medications, her blood pressure remained uncontrolled, with systolic readings exceeding 200 mmHg [7][10]. - The patient began treatment with liraglutide in 2013, which reduced her systolic blood pressure from 206 mmHg to 160 mmHg over six years [8]. - In 2019, the treatment was switched to dulaglutide, and in 2023 to terzepatide, resulting in a further reduction of systolic blood pressure to 135 mmHg, indicating the effectiveness of GLP-1/GIP receptor agonists [9][10]. Group 3: Mechanisms of Action - GLP-1/GIP receptors are widely distributed in the hypothalamus, carotid body, vascular endothelium, and kidneys. Animal studies suggest these agonists may lower blood pressure by inhibiting sympathetic nervous system activity, improving endothelial dysfunction, and/or reducing vascular remodeling [12]. - The case study suggests that GLP-1/GIP receptor agonists may have broader applications in blood pressure control, particularly for resistant hypertension, indicating a need for further exploration of their mechanisms [12].