Blood pressure control and the implementation of guidelines in clinical practice: can we fill the gap?
Blood pressure control and the implementation of guidelines in clinical practice: can we fill the gap?
复制标题
血压控制与临床实践指南的实施：我们能填补空白吗？
DOI：
10.1097/00004872-200207000-00002
复制
发表时间：
2002
影响因子：
4.9
通讯作者：
M. Burnier
中科院分区：
文献类型：
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作者：
M. Burnier
在过去的四十年中，新的、有效的和耐受性良好的抗高血压药物的显著发展丰富了高血压的管理。使用这些药物进行的多项临床试验提供了令人信服的证据，表明降低血压是降低心血管发病率和死亡率的一种非常有效的方法，因此，今天几乎没有任何医生会真正质疑治疗高血压的必要性。然而，对高血压护理质量进行严格评估的众多国家或地方调查一致表明，未知高血压患者的患病率和血压不受控制的经治疗高血压患者的百分比仍然很高[1-6]，尽管有所有的信息策略和快速增长的国家和国际高血压管理指南的传播[7- 10]。因此，来自美国国家健康和营养检查调查的数据显示，高血压人群的知晓率已从20世纪70年代的50%提高到20世纪90年代的约70%[1]。与此同时，接受治疗的高血压患者血压正常的比例也从10%增加到29%，但最近的调查发现这些数字稳定在27% [1]。在欧洲，几项研究报告血压控制的百分比在6%到30%之间[2- 4，6]。
During the last four decades, the management of hypertension has been enriched by the remarkable development of new, effective and well-tolerated antihypertensive drugs. The multiple clinical trials performed with these agents have provided compelling evidence that lowering blood pressure is a very effective way to reduce cardiovascular morbidity and mortality so that, today, hardly any physician would really dispute the need to treat hypertension. Yet, the numerous national or local surveys which have provided a critical appraisal of the quality of hypertension care have consistently demonstrated that the prevalence of patients with unknown hypertension and the percentage of treated hypertensive patients with an uncontrolled blood pressure remain high [1–6], despite all information strategies and the rapidly growing diffusion of national and international guidelines for the management of hypertension [7–10]. Thus, data from the National Health and Nutrition Examination Surveys in the USA show that the awareness of the hypertension population has improved from 50% in the 1970s to approximately 70% in the 1990s [1]. Over the same time, the percentage of treated hypertensive patients with a normal blood pressure has also increased from 10 to 29%, but the most recent survey has found a stabilization of these figures at 27% [1]. In Europe, several studies have reported a percentage of controlled blood pressure ranging between 6 and 30% [2–4,6].