Clinical guidelines for the treatment of hypertension in African Americans.
Clinical guidelines for the treatment of hypertension in African Americans.
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DOI：
10.2165/00129784-200505010-00001
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Douglas, Janice G
中科院分区：
文献类型：
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作者：
Douglas, Janice G
非裔美国人是世界上高血压患病率最高的人群，与美国白人相比，他们发病更早、更严重、控制率更差、心血管和肾脏并发症更多。与白人相比，非裔美国人2型糖尿病的高患病率加重了心血管和肾脏疾病的负担。国际黑人高血压学会的非裔美国人高血压工作组最近制定了一份共识文件，提出了一种实用的、以证据为基础的方法，旨在实现更好的血压控制。人们认为，需要一种针对美国黑人的新方法来实现更好的血压控制和增强靶组织保护。该文件的关键要素包括(i)强调治疗性生活方式改变的重要性，如减肥、减少钠摄入量、增加钾摄入量、运动和减肥等；（ii）推荐联合降压药，因为>高于收缩压目标15毫米汞柱和/或高于舒张压目标10毫米汞柱的个体患病率很高（140/90，除非同时患有糖尿病和/或肾脏疾病并每日>g蛋白尿）。有效的组合包括-肾上腺素能受体拮抗剂/利尿剂、ACE抑制剂/利尿剂、ACE抑制剂/钙通道拮抗剂和血管紧张素受体拮抗剂/利尿剂；（iii）建议与其他种族/民族人群没有区别，在这些人群中存在使用特定类别降压药的特定或令人信服的适应症。
African Americans represent a population with the highest prevalence of hypertension in the world, associated with earlier onset, more severity, poorer control rates, and more cardiovascular and renal complications than White Americans. The high prevalence of type 2 diabetes mellitus in African Americans, compared with Whites, compounds the excessive burden of cardiovascular and kidney disease. The Hypertension in African American Working Group of the International Society of Hypertension in Blacks recently developed a consensus document that presented a practical, evidence-based approach aimed at achieving better blood pressure control. It was thought that a new approach, targeted at US Blacks, was needed to achieve better blood pressure control and enhanced target tissue protection. Key elements of the document include (i) emphasis on the importance of therapeutic lifestyle modification such as weight loss, decreased sodium ingestion, increased potassium intake, exercise, and weight loss, to name a few; (ii) recommendation of combination antihypertensive agents because of the high prevalence of individuals with >15 mm Hg above SBP goal and/or 10 mmHg above DBP goal (140/90 unless there is also diabetes and/or kidney disease with >1 g proteinuria daily). Effective combinations include beta-adrenoceptor antagonist/diuretic, ACE inhibitor/diuretic, ACE inhibitor/calcium channel antagonist, and angiotensin receptor antagonist/diuretic; and (iii) the recommendations do not differ from other racial/ethnic groups where specific or compelling indications for the use of specific classes of antihypertensive agents exist.