Using Predicted Cardiovascular Disease Risk in Conjunction With Blood Pressure to Guide Antihypertensive Medication Treatment.

Using Predicted Cardiovascular Disease Risk in Conjunction With Blood Pressure to Guide Antihypertensive Medication Treatment.
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DOI:
10.1016/j.jacc.2017.02.066
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发表时间:
2017-05-16
影响因子:
24
通讯作者:
Whelton PK
Whelton PK
中科院分区:
医学1区
文献类型:
--
作者:
Muntner P;Whelton PK

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使用心血管疾病(CVD)风险代替血压(BP)或与血压(BP)一起指导抗高血压治疗是一个活跃的研究领域。本综述的目的是提供可能为这种治疗范式提供信息的研究概述。我们回顾了随机试验的数据,这些试验涉及在 CVD 风险指导下进行抗高血压治疗时可能发生的相对和绝对 CVD 风险降低。我们回顾了有关使用 CVD 风险与血压联合指导抗高血压治疗的人群水平数据、血压水平相似人群 CVD 风险的广泛分布,以及使用 CVD 风险指导亚组(包括老年人、年轻人和糖尿病或慢性肾病患者)的抗高血压治疗。此外,我们还回顾了实施纳入 CVD 风险的抗高血压治疗建议的潜在挑战。最后,我们提供了将 CVD 风险与血压结合起来指导抗高血压治疗的建议。
Using cardiovascular disease (CVD) risk instead of, or in addition to, blood pressure (BP) to guide antihypertensive treatment is an active area of research. The purpose of this review is to provide an overview of studies that may inform this treatment paradigm. We review data from randomized trials on relative and absolute CVD risk reduction that may occur when antihypertensive treatment is guided by CVD risk. We review population-level data on using CVD risk in conjunction with BP for guiding antihypertensive treatment, the broad distribution in CVD risk for people with similar BP levels, and the use of CVD risk for guiding antihypertensive treatment among sub-groups including older adults, young adults and those with diabetes or chronic kidney disease. Also, we review potential challenges in implementing antihypertensive treatment recommendations that incorporate CVD risk. In closing, we provide recommendations for using CVD risk in combination with BP to guide antihypertensive treatment.
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