Total cardiovascular risk: a new treatment concept
Total cardiovascular risk: a new treatment concept
复制标题
DOI：
10.1097/01.hjh.0000220099.12154.c1
复制
发表时间：
2006-04-01
影响因子：
4.9
通讯作者：
Mancia, Giuseppe
中科院分区：
文献类型：
--
作者：
Mancia, Giuseppe
认识到心血管危险因素，如高血压、血脂异常和糖尿病往往聚集在一起，已将注意力集中在总心血管风险的概念上。大多数当前的高血压管理指南强调评估和管理单个患者的总风险的重要性。由于存在额外的风险因素、靶器官损害和相关的临床条件，即使患者的血压正常或高正常(收缩压130-139毫米汞柱，舒张压80-89毫米汞柱)，患者也可能处于心血管事件的高危状态。这种高危患者虽然在临床实践中很常见，但往往被低估。建议对高危患者进行强化高血压治疗。在大多数情况下，这将需要两种或两种以上药物的联合治疗。此外，抗高血压治疗应该成为旨在治疗所有可逆危险因素的多因素方法的一个组成部分。在未来，研究的目标应该是控制或逆转亚临床靶器官损害，最终目的是防止低风险或中等风险个体心血管风险的进展。
Recognition that cardiovascular risk factors, such as hypertension, dyslipidaemia and diabetes mellitus, often cluster together has focused attention on the concept of total cardiovascular risk. Most current hypertension management guidelines emphasize the importance of assessing and managing the total risk in an individual patient. Due to the presence of additional risk factors, target-organ damage and associated clinical conditions, patients may be at high risk of cardiovascular events even when their blood pressure is normal or high-normal (systolic blood pressure 130-139 mmHg, diastolic blood pressure 80-89 mmHg). Such high-risk patients, although common in clinical practice, are often under-diagnosed. Intensive hypertensive therapy is recommended for high-risk patients. In most cases, this will necessitate combination therapy with two or more drugs. Moreover, antihypertensive therapy should form one component of a multifactorial approach aimed at treating all reversible risk factors. In the future, research should be aimed at controlling or reversing subclinical target-organ damage, the ultimate aim being to prevent the progression of cardiovascular risk in individuals at low or medium risk.