Overdiagnosis or not? 2017 ACC/AHA high blood pressure clinical practice guideline: Consequences of intellectual conflict of interest.
Overdiagnosis or not? 2017 ACC/AHA high blood pressure clinical practice guideline: Consequences of intellectual conflict of interest.
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DOI：
10.1002/jgf2.176
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发表时间：
2018-07
影响因子：
1.6
通讯作者：
Miyazaki K
中科院分区：
文献类型：
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作者：
Miyazaki K
美国心脏协会/美国心脏病学会等9个专业组织于2017年11月发布了新的高血压临床实践指南（CPG），将高血压阈值降低至130/80 mmHg。美国家庭医学学会决定不支持这种新的CPG，原因有很多，包括CPG开发过程中的缺陷和较低治疗目标的有限额外益处。主要关切是知识产权利益冲突。SPRINT试验得到了相当大的重视，它为血压目标的建议变化提供了基础。SPRINT试验指导委员会主席被委任为指南小组主席，这是一个严肃的知识产权问题。新的阈值将导致46%的美国成年人被归类为高血压，而使用以前的阈值，这一数字将是32%。我们应该把这种变化称为过度诊断吗？
American Heart Association/the American College of Cardiology and nine other professional organizations have issued a new hypertension clinical practice guideline (CPG) on November 2017, which has lowered the hypertension threshold to 130/80 mmHg. American Academy of Family Medicine has decided to not endorse this new CPG for various reasons including flaws in CPG development process and a limited additional benefit for lower treatment targets. The major concern was intellectual conflict of interest (COI). Substantial weight was given to SPRINT trial, which provided the basis for the recommended change in blood pressure targets. It is a serious intellectual COI that the Chair of the SPRINT trial steering committee was commissioned as chair of the guideline panel. The new threshold would lead to 46 percent of the U.S. adult population being categorized as having hypertension, while using the previous threshold that figure would be 32 percent. Should we call this change as overdiagnosis?