Pregledni rad
What is the Best Way to Treat Patients with Raynaud’s Phenomenon and a Tendency towards Hypotension?
Hanna Helena Drobek
; Medical University of Silesia in Katowice, Katowice, Poland
Mateusz Porwolik
; Medical University of Silesia in Katowice, Katowice, Poland
Kornelia Pietrauszka
; Medical University of Silesia in Katowice, Katowice, Poland
Bartosz Miziołek
; Medical University of Silesia in Katowice, Andrzej Mielecki Independent Public Clinical Hospital in Katowice, Katowice, Poland
Beata Bergler-Czop
; Department of Dermatology, Medical University of Silesia in Katowice, Andrzej Mielecki Independent Public Clinical Hospital in Katowice, Katowice, Poland
Ligia Brzezińska-Wcisło
; Department of Dermatology, Medical University of Silesia in Katowice, Andrzej Mielecki Independent Public Clinical Hospital in Katowice, Katowice, Poland
Sažetak
Episodes of excessive vasospasm are common in patients with
Raynaud’s phenomenon (RP). Pharmacological treatment may often result in
side-effects such as hypotension, leading to discontinuation of treatment. Review
of therapeutic interventions with regard to tendency towards hypotension
was done in medical databases including PubMed, Scopus, and Medline to summarize
the current state of the knowledge. Despite the episodes of blood pressure
drops caused by hypotension, calcium channel blockers (CCB) have been
widely used in RP as first-line treatment medication. The use of other CCB apart
from nifedipine is controversial due to the variety of results in clinical trials. A
clinical study comparing the efficacy and tolerability of losartan with nifedipine
revealed a significant reduction in RP severity, frequency of episodes, and
reported adverse effects. Application of oral sildenafil 100 mg/d as an add-on
therapy increased microvascular blood flow in secondary RP, while being welltolerated
and with no withdrawal from the study. Topical vasodilators may be
applied as an adjuvant therapy for patients with RP. Clinical studies approved
10% nifedipine cream and 10% nitroglycerine gel as an efficient RP therapy with
side-effects comparable with placebo usage. Non-pharmacological interventions,
such as cold avoidance, stress management, and smoking cessation are
recommended in reducing episodes of RP.
Calcium channel blockers, with a particular emphasis on nifedipine, in combination
with non-pharmacological management seem to be the optimal way to
treat the patients with a tendency to hypotension
Ključne riječi
Raynaud’s phenomenon, vasospasm, hypotension, symptoms, treatment
Hrčak ID:
281293
URI
Datum izdavanja:
16.9.2020.
Posjeta: 550 *