[Treatment of arterial hypertension in patients with organ transplantation].
The onset of predominantly systolic hypertension (HT) is the most common complication following organ transplantation. The hypertension is directly linked to the immunosuppressant treatment, particularly to the nephrotoxic and intrarenal and peripheral vasoconstrictor effects of cyclosporin. Treatment is based on the primary use of arteriolar vasodilators, but must be appropriate for the organ transplanted and the degree of HT. It is often necessary to administer two or three antihypertensive drugs, which must take into account the precautions for their use and possible interactions with cyclosporin: calcium channel inhibitors inhibit the vasoconstriction induced by cyclosporin, converting enzyme inhibitors slow the compensatory glomerular hyperfiltration, diuretics are effective versus this type of HT, which is sensitive to sodium depletion, and beta-blockers are useful in hypertensive patients who have undergone kidney or liver transplants, but less commonly used in cardiac transplant patients. Centrally-acting antihypertensives are used as a second option.
Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-Louis, Paris.
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D
Farge
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Julien
D000959:Antihypertensive Agents / Q000145:classification* / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects*
D000959:Antihypertensive Agents
Traitement de l'hypertension artérielle chez le transplanté d'organe.