Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline
Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline
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DOI：
10.7326/m17-3203
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发表时间：
2018-03-06
影响因子：
39.2
通讯作者：
Whelton, Paul K.
中科院分区：
文献类型：
--
作者：
Carey, Robert M.;Whelton, Paul K.
产品描述：2017年11月，美国心脏病学会（ACC）和美国心脏协会（AHA）发布了预防，检测，评估和治疗成人高血压（BP）的临床实践指南。方法：2014年，ACC和AHA任命了一个多学科委员会来更新国家联合委员会关于预防、检测、评估和治疗高血压的报告。该委员会回顾了文献，并委托进行了系统评价和荟萃分析，内容涉及门诊血压监测、血压降低的最佳目标、不同类别降压药的比较获益和危害，以及开始使用单一降压药或两种药物联合治疗的比较获益和危害。建议：本文总结了以下方面的关键建议：血压分类、血压测量、继发性高血压筛查、非药物治疗、指导药物治疗的血压阈值和心脏风险估计、治疗目标（一般和糖尿病、慢性肾脏疾病和高龄患者）、初始药物治疗的选择、顽固性高血压和改善高血压控制的策略。
Description: In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a clinical practice guideline for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults. This article summarizes the major recommendations.Methods: In 2014, the ACC and the AHA appointed a multidisciplinary committee to update previous reports of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The committee reviewed literature and commissioned systematic reviews and meta-analyses on out-of-office BP monitoring, the optimal target for BP lowering, the comparative benefits and harms of different classes of antihypertensive agents, and the comparative benefits and harms of initiating therapy with a single antihypertensive agent or a combination of 2 agents.Recommendations: This article summarizes key recommendations in the following areas: BP classification, BP measurement, screening for secondary hypertension, nonpharmacologic therapy, BP thresholds and cardiac risk estimation to guide drug treatment, treatment goals (general and for patients with diabetes mellitus, chronic kidney disease, and advanced age), choice of initial drug therapy, resistant hypertension, and strategies to improve hypertension control.