高血压表型和合并症个体化治疗策略的多专业共识。

Q3 Medicine
Gurpreet S Wander, Kamlesh Tewary, A Muruganathan, Agam C Vora, Girish Mathur, Chenniappan Meenakshisundaram, Narinder P Singh, Anup Barman, Munish Prabhakar, Nandini Chatterjee, Sujoy Ghosh, Puneet Saxena, Nihar Mehta, Jayanta K Panda, Sekhar Chakraborty, G D Ramchandani, Debaprasad Chakraborty, Saikat Datta, Mrinal K Roy, Amit A Saraf, Dwijen Das, Chandni Radhakrishnan, Devendra P Singh, M Ravikeerthy, Sandip Mitra
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引用次数: 0

摘要

高血压(HTN)仍然是全球发病率和死亡率的主要原因,通常与糖尿病、慢性肾病(CKD)、冠状动脉疾病(CAD)、心力衰竭(HF)和肥胖等主要合并症共存。在印度,相当大比例的高血压患者仍未得到诊断或治疗不足。这一多专业共识为针对特定表型和合并症的个体化HTN管理提供了全面的、基于证据的建议。通过有组织的专家小组讨论以及对国际和国家指南的审查,共识强调了办公室外血压(BP)监测、表型识别(例如,白大褂、蒙面、夜间HTN)和目标器官损伤的早期发现。该文件概述了实用算法和治疗轮,以指导基于患者特异性因素的降压治疗,促进根据临床情况使用血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体阻滞剂(ARBs)、钙通道阻滞剂(CCBs)、β受体阻滞剂(BB)和利尿剂。对于年轻成人、心动过速、中风和呼吸系统疾病患者的HTN管理,我们提供了特殊的考虑。共识还提倡改变生活方式,坚持治疗,多学科护理,以改善血压控制和长期预后。通过促进整体的、以患者为中心的方法,这一共识旨在弥合临床实践中的差距,并在不同的医疗保健环境中标准化HTN的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Multispecialty Consensus on Individualized Treatment Strategies for Hypertension Phenotypes and Comorbidities.

Hypertension (HTN) remains a leading contributor to global morbidity and mortality, often coexisting with major comorbidities such as diabetes, chronic kidney disease (CKD), coronary artery disease (CAD), heart failure (HF), and obesity. In India, a significant proportion of hypertensive individuals remain undiagnosed or inadequately treated. This multispecialty consensus provides comprehensive, evidence-based recommendations for individualized HTN management tailored to specific phenotypes and comorbidities. Developed through structured expert panel discussions and a review of international and national guidelines, the consensus emphasizes out-of-office blood pressure (BP) monitoring, phenotype recognition (e.g., white-coat, masked, nocturnal HTN), and early detection of target organ damage. The document outlines practical algorithms and a therapeutic wheel to guide antihypertensive therapy based on patient-specific factors, promoting use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-blockers (BB), and diuretics, as per clinical context. Special considerations are provided for managing HTN in young adults, patients with tachycardia, stroke, and respiratory disorders. The consensus also advocates for lifestyle modifications, treatment adherence, and multidisciplinary care to improve BP control and long-term outcomes. By promoting a holistic, patient-centered approach, this consensus aims to bridge gaps in clinical practice and standardize the management of HTN in diverse healthcare settings.

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