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JACC：2014版高血压防控专家意见对当前心血管临床治疗的意义：NCDR PINNACLE 注册处的观点

2014-12-01 MedSci译 MedSci原创

高血压防控血压管理
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背景：自2003年以来，JNC-7（全国联合委员会第七次报告）一直是血压管理的主要指南。2014年专家组建议提高60岁及以上患者，以及患有糖尿病或慢性肾病病人的血压控制目标值。目的：本研究的目的是检验2014年专家组的血压管理的建议对于美国门诊部心血管病人治疗的影响。方法：采用全国心血管数据注册PINNACLE的数据，我们评估了符合2003和2014专家意见定义的高血压病人的比例，并找到血压目标值

背景：自2003年以来，JNC-7（全国联合委员会第七次报告）一直是血压管理的主要指南。2014年专家组建议提高60岁及以上患者，以及患有糖尿病或慢性肾病病人的血压控制目标值。

目的：本研究的目的是检验2014年专家组的血压管理的建议对于美国门诊部心血管病人治疗的影响。

方法：采用全国心血管数据注册PINNACLE的数据，我们评估了符合2003和2014专家意见定义的高血压病人的比例，并找到血压目标值变化了的患者。

结果：在1185253例患者中，706859（59.6%）按照2003版 JNC-7的标准血压控制已达标。以2014版专家建议为标准，880378（74.3%）患者的血压控制达标。在173519例（14.6%）血压目标值变化的人里，40323（23.2%）之前发生过一次中风或短暂性脑缺血发作，112174（64.6%）有冠状动脉疾病。此外，这组的Framingham平均危险评分为8.5±3.2%，10年动脉粥样硬化性心血管疾病的风险评分为28±19.5%。




结论：美国门诊部患有高血压的心血管患者，将近七分之一在JNC-7建议中没有实现治疗目标，却已满足2014版本指南的治疗目标。如果新的建议在临床实践中运用，血压的达标与心血管事件都需要仔细监测，因为许多患者的目标血压现在更宽松，却存在较高的心血管病风险。

原始出处：

William B. Borden, MD; Thomas M. Maddox, MD, MSc; Fengming Tang, MS; John S. Rumsfeld, MD, PhD; William J. Oetgen, MD, MBA; J. Brendan Mullen, BSFS; Sarah A. Spinler, PharmD (AQ Cardiology); Eric D. Peterson, MD, MPH; Frederick A. Masoudi, MD, MSPH.Impact of the 2014 Expert Panel Recommendations for Management of High Blood Pressure on Contemporary Cardiovascular PracticeInsights From the NCDR PINNACLE Registry.J Am Coll Cardiol. 2014;64(21):2196-2203. doi:10.1016/j.jacc.2014.09.022


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    2015-09-20 hbwxf

    #JACC#

    0

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    2014-12-03 12498568m50暂无昵称

    #ACC#

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    2014-12-03 xuyong527

    #临床治疗#

    0

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    2014-12-03 zhyy93

    #注册#

    0