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MUDr.3401485013793168245287311
Eva6731485013759116173
Kociánová,8691485013767128178209267332396452510540
Ph.D.14311485013764127156235261
I.340163901332650
interní413163901332686121175210271296
klinika733163901335178103163188239293
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kardiologická,11281639013351105140201227287313373435460509559613636
FN17871639013354124
Olomouc19341639013376102162254314375424
Poškození3402148012153106145192246288338394418
funkce777214801212985140187231280
ledvin1076214801212474132180205260
patří13552148012156105138171195
mezi15692148012183133177201
podceňovaná17892148012156112170215264320375422471526574
rizika2382214801213357100124171220
nekompenzované26212148012155106153207290347398454497552600648704754
hypertenze.33942148012155101159210243280329385340228801214293114
Dlouhodobé473228801216691147202258313371426484535
nepříznivé10282288012155106163196220264320343392442
působení14892288012156112152207265316372396
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krevního2327228801214681131179236259317372
tlaku2719228801213357105152208
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již338222880121244891
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věku.579242801214898145201223
V8222428012155
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hypertenzního12812428012156102160212246282332388432488512570626
poškození19262428012157114154201255298348405429
ledvin2374242801212475133182207262
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časná3164242801214494134189238
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a3402568012148
důsledná4062568012156110150173223280335383
léčba808256801212374119175224
hypertenze.10512568012155100157208241277326382425475495
Podle15652568012152105162186236
nových18202568012155110157207251306
doporučení21452568012155110167223256311356405460483
je2647256801212474
třeba2740256801213365115172220
vést2979256801214897136170
léčbu3168256801212373119175230
k34172568012146
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hodnotám3402708012155109166221276308357439
TK7982708012149103
<9202708012159
130/80997270801215195145178227279
mmHg,12952708012182164229285306
kterých1619270801214782131164214258312
by19502708012156102
mělo20712708012182132156211
být23002708012156103139
dosaženo24572708012156111150198241291346401
optimálně28772708012154110143167249297320375425
do33202708012156111
334492708012151
měsíců35182708012182133172195239293
od3402848012154110
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terapie.829284801213381114162217241290310
U11572848012163
každého1238284801214695137193242297351
hypertonika1607284801215599156206239274328383405451500
je2125284801212373
navíc22162848012154101147171215
doporučeno24492848012155109165221253309354403459514
vyšetřovat2983284801214798138188222255310357406439
nejméně34422848012154105129212263319369
1×3402988012151106
ročně473298801213390137194247
glomerulární747298801215681139224277312369394444479537562
filtraci133629880121305883118152203250275
a16382988012148
albuminurii1714298801214873132189275300357414448474499
(pomocí2240298801212987145231288336361
poměru26282988012157115201253288345
albumin3001298801214873132189274300357
:33852988012121
kreatinin3433298801214783135184218242298322378
v3403128012148
moči).4113128012183139186209238257
V6913128012156
terapii769312801213384117167225249273
pacientů10653128012157107152176227284317373
s14613128012139
hypertenzí15233128012155102161213246283334390434459
a20043128012149
chronickou20753128012145101134190247271316364419475
renální2572312801213384141190214270294
insuficiencí2889312801212379119175205232278302353410456480
je3391312801212576
zásadní3489312801214394134184242298322
kompenzace3403268012147102186244296353397448493543
krevního913326801214782133181238262321377
tlaku,1319326801213357106154210232
restrikce1580326801213384124159193217265310360
konzumace19693268012147101158202258343392437487
soli2486326801213996121145
a26603268012148
výběr27373268012148100159210244
nefroprotektivních30103268012156107138173228286320376410460508545569618675700745801
antihypertenziv,3403408012148104138162218265323375409446496553597622671688
zejm.1055340801214394118203225
ACEI,13073408012161117167191213
které1547340801214784134168219
je1793340801212476
třeba1896340801213366117175225
titrovat214834080121335791125180228278311
k24863408012147
nejvyšší25603408012156107132181233273313337
tolerované2924340801213489114165199254303352408460
dávce.34113408012156105153197247269
Již3707340801213761104
ve340354801214898
druhém461354801215690146202254338
kroku822354801214782138186242
léčby1087354801212375121179226
hypertenze13353548012156102161213247284334391435486
je1844354801212475
doporučena19423548012156112170227261317363413470519
trojkombinace2484354801213366122146194249333391416472521567617
antihypertenziv,31233548012149105138162219265324376410447497554598622671688
pokud3403688012156112159214271
ani6293688012148103126
ta774368801213382
není8753688012154105160183
dostatečná,10773688012156111150184233265315360415463484
přidává1580368801215689113169217264312
se1911368801213989
nejčastějii20193688012155105129174222261295344368392415
spironolakton.2453368801213996119152206262317341389435471525581602
Z30743688012155
diuretik3147368801215679134167216250273320
by34853688012157103
měla36073688012182132156204
být3403828012157103140
preferována500382801215690140170221254309357406462510
thiazidová1029382801213389113161205229286341389438
a14863828012148
thiazidům1554382801213288112160204228285340423
podobná19973828012156113170226283339388
diuretika,2404382801215680135168218252276323373395
pouze28183828012157113169212263
při3100382801215690114
hypervolemii,32333828012155101160211244296350375426510533557578
pokročilé3403968012157113161196251297321345395
renální755396801213383139188212268291
insuficienci1066396801212379119174204231276300351407452476
nebo15623968012155106163220
srdečním1801396801214073129180226282306390
selhání2210396801214091115171220276299
je2529396801212475
vhodný26243968012147104160217273319
furosemid.2963396801212985119174214265349373430451
Při3434396801215385109
výpočtu3563396801214899157214340410801214581137
kardiovaskulárního499410801214797131188212268316366406454510534583617674698756812
rizika1333410801213358101126173224
pacientů15794108012157107152176228284318373
s19754108012139
hypertenzí20374108012155102160212246283333390434459
je2518410801212475
třeba2616410801213366117175225
zohlednit2863410801214399155180231290346370404
i32894108012124
přítomnost3335410801215791115149204289345401442476
albuminurie340424801214873130186271295351407440465516
a8794248012149
u9514248012155
pacientů10294248012157107152176228284318373
s14264248012139
vysokým14884248012148100141197245297382
KV18934248012154115
rizikem2031424801213257101125173223307
podávat23624248012156113172221268318351
statin.2736424801214075125158182238260
Klíčová340441501246088115159216267318
slova:674441501244371128178230255
hypertenze,946441801215599155205237272320374416465484
chronická1447441801214498129182237259303348396
renální1859441801213381136182205259281
insuficience,2157441801212377115168196221265287336390434482501
proteinurie,2675441801215688141173221244298351382405454473
antihypertenzní31654418012148101133155209253309359391426474529570625647
léčba.340455801212474120176225246
How3404835012469127203
to563483501243795
prevent678483501246099152204256316352
organ1051483501245796155209268
damage13394835012460113200253312366
in1725483501242786
patients18324835012459113150178231291328372
with22244835012476104142202
hypertension24464835012458109170224263302355415459487545604
–30704835012450
focusing3140483501243593139197242270329388
on35484835012458117
the340497501243797150
kidneys510497501245484144203256308351
Renal3405148012153103157204227
impairment5845148012123105161209231263345395449481
is1082514801212361
one11605148012154109159
of1336514801215482
the1435514801213387137
underestimated15895148012154108164213245294333366388470517549597654
risks226051480121325593139180
of2457514801215583
uncompensated25575148012155109153206288344394448487535566615671
hypertension.3245514801215599156206238273322376415437491545566
Long-term3405288012147102157213245279328361444
adverse8095288012148105154203235276326
effects1160528801215080113163209244284
of1469528801215584
high1578528801215679135190
blood1793528801215781136191249
pressure2067528801215689139179218272305355
are2446528801214981131
risky260252880121325695142192
from2819528801212963117201
a30455288012148
young31185288012147101156211267
age.34105288012148104155175
Early3610528801214998130154201
diagnosis340542801215680127183239294333356395
and7555428012148103160
consistent935542801214599154193216255289338394426
treatment1381542801213466116164197280330386418
of1819542801215584
hypertension19235428012156101159210243279328384423446501556
are2499542801214981131
needed26505428012155106157214264322
in2992542801212378
the3090542801213389139
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of3727542801215584
hypertensive3405568012156102160211244281330386426449497547
kidney915556801214873130185236283
damage.12275568012156105188237293344364
According16205568012161105149203237293317372429
to2077556801213388
the2193556801213489140
new23625568012155106180
recommendations,2570556801213383129184268351402458515564597620675731771792
treatment3391556801213366116164197281332388420
should340570801214097154210235293
be6625708012158110
guided8025708012157113137195247306
to1137570801213489
target1256570801213384117174226261
BP15465708012155110
values1686570801214998123179231271
<19835708012160
130/802069570801215296146177226278
mmHg,23725708012185168233289309
which27065708012175130152196251
should2982570801214095150204227283
be32905708012158108
optimally34245708012156112144166249297319341388
achieved340584801214890143164212257304359
within713584801217394125178199252
39785848012151
months10435848012183136189219272309
of1365584801215582
therapy.1461584801213385134164210265309323
In1797584801212477
addition,18885848012148102156177208229282335353
it2255584801212354
is2323584801212360
recommended2397584801213280123175256336385438492540595
that3006584801213385131161
every3181584801215095142172220
hypertensive3415584801215599154203233267314367340598801214060107154
patient5115988012157104135156204258288
be8165988012157106
examined940598801215095141223244297345401
glomerular1358598801215678131212261292345367413443
filtration181959880121295374105136182213234287341
rate2177598801213379110157
and23525988012148101156
albuminuria2525598801214970124178259280333386417438484
(using3027598801212878115136189243
the3288598801213386134
albumin3440598801214870124177259280333
:37915988012120
creatinine340612801214575123169200221274295348397
ratio754612801213379110131184
in955612801212377
the1049612801213386135
urine)1201612801215585107160209232
at1450612801214979
least1546612801212472118155187
once17516128012155108151198
a19676128012148
year.2032612801214795141171185
In2235612801212477
the2329612801213387135
management24816128012184130183229283331413461515545
of3044612801215582
patients31436128012157104134155203257287326
with3486612801217496127180
hypertension36836128012156993406268012157106137170218271308329382435
and7896268012149102156
chronic959626801214598128181234255298
renal1271626801213380134180201
insufficiency,1486626801212376113166193224248290311359413456503517
blood2017626801215779132186241
pressure2272626801215787135173210262292340
compensation,2626626801214596178232281335372419449470523577595
salt3235626801214087108139
restriction,3388626801213280118149180201244277298351405423
and3406408012148101156
the510640801213386134
selection658640801214088110158202235256309362
of1034640801215582
nephroprotectives,11306408012155104159213243295350381434464512555588609656703740759
especially1903640801215087142191234255301322343389
the2305640801213487135
use2454640801215592140
of2608640801215582
non-fetal27046408012155108162192220268299346368
antihypertensives,30856408012149102132153206249305354385419466519556577623670708727
where3406548012174127176207255
ACEIs6116548012161114161182219
should846654801214093146200221276
be11386548012156105
titrated126065480121335485115162192240295
to1571654801213385
the1672654801213386135
highest1823654801215577130184232270302
tolerated2141654801213385107155186233263310366
dose,25236548012156109146195213
are2752654801214879126
essential.2895654801215087124173226257278324345364
In3275654801212477
the3368654801213387135
second3519654801214088132184237292
step340668801214071119174
of533668801215582
the634668801213386135
treatment788668801213363111157188269317371401
of1208668801215582
hypertension,1309668801215699155204235269316370407428481535553
a18816688012148
triple194866880121346486140162211
combination2178668801214496178233254307353384405458512
of2709668801215582
antihypertensive28106688012148101131152206249305354385419466520557578624671
drugs3500668801215687140194232
is3751668801212360
recommended.340682801213381124176258339387441496544599618
If980682801212452
it1053682801212455
is1130682801212360
insufficient,1212682801212377114166193224248291312360414444463
spironolactone1697682801214094116146199252306328374416450502555604
is2323682801212360
most24056828012183137174206
often2632682801215582117164218
added.28726828012148102157205261280
Of3174682801216897
the3293682801213386135
diuretics,3450682801215677130160208240261303342361
thiazide340696801213386107153195216271319
and6766968012148102156
thiazide-like849696801213387108154195216271319351374394439486
diuretics1352696801215678130161209240261304343
should1712696801213992146199220275
be20046968012157106
preferred,2127696801215788136163212243274321377395
only25406968012154108130175
in2732696801212377
hypervolemia,2826696801215599154204234284335358406487509555574
advanced34176968012148103149195249292339394
renal340710801213381134180202
insufficiency,565710801212377114166193224248291312360414457504518
or1107710801215586
heart12167108012156104150181214
failure145471080121297697118171202249
furosemide1727710801212983113166203252333354409457
is2208710801212360
suitable.2292710801213992113144191245268316334
When26497108012185139187241
calculating2913710801214592113156209230276307328381435
the3372710801213386134
cardiovascular3530710801214491122176197250340724801214895132175228249295325
risk68572480121325491136
of840724801215582
hypertensive941724801215699155204235269316370407428474521
patients,14817248012157104134156204257288326345
the1846724801213386134
presence2000724801215787135173221275318365
of2384724801215582
albuminuria2485724801214970125178259280334386417438484
should2988724801214093146200221276
be32837248012157106
taken3408724801213380125172225
into3653724801212376106159
account340738801214891133184238291321
and6787388012149102157
a8527388012148
statin917738801214072119149170223
should1157738801214093146200221276
be14507388012157106
administered15737388012148103184205258279317348396427474530
in2120738801212376
patients22147388012157103134155203257287326
at2557738801214879
high2653738801215576130184
CV28547388012158114
risk.298573880121335491136157
Key3407555012461113164
words:5297555012475133171232276302
hypertension,8567558012156101159210243279328384423445501556577
chronic14587558012145100133187243266311
renal1794755801213383138186210
insufficiency,2029755801212479118172202234260305328378434479529545
proteinuria,2599755801215790144177227250305360392416464485
antihypertensive31097558012149104136159214260318369402438487543582604653702
treatment.340769801213366115163196279330385418439
DECLARATIONS:4068215908648871301662142563043393604124625014570216008514
Declaration406822960874987120141179207245272292334376
of445822960874166
originality:45382296087406888131151193231252272299338358
The406824080853473109
manuscript418824080855791130168195227249266306329
is452824080851644
original45832408085386178117133172205222
and481624080853472112
has49392408085387299
not50502408085387699
been516124080853975110149
published532124080854078118135151178217252292
or406825180853862
submitted414525180852867108167184208234269310
elsewhere.44702518085355381117169209246269305320
Ethical406826540873764107127160198219
principles43012654087427090132165185229249288319
compliance:463526540873172134177198218256298331369388
The406827670853678116
authors420527670853475100142183208238
attest44642767085356087124154179
that466427670852465101126
their481127670852465103121146
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by406828770854073
the41582877085236399
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Committee464828770854179139198215239265300337
and500128770853474114
is513228770851745
in519428770851656
compliance526628770853270130170188205239279311347
with40682987085537298140
human423629870854081143180221
studies44862987085285496139157195226
and474029870853577119
animal48882987085347695156193212
welfare512829870855391110133170196233
regulations53902987085236110414516420140683097085234080120148
of423630970853859
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