一个正常血压高的病人,我们应该治疗吗?

Danuta Czarnecka, Grzegorz Bilo
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引用次数: 3

摘要

目前血压(BP)如果低于140 mmHg的收缩压和90 mmHg的舒张压被认为是正常的(对大多数受试者来说)。然而,死亡风险与低于临界值的血压水平呈近似线性关系。因此,人们现在更多地关注那些血压水平保持在正常范围内但接近140/90 mmHg水平的人群。2003年的ESH-ESC指南将血压在130/85和139/89 mmHg之间定义为“高正常”,而2003年的JNC7指南引入了一个新的类别“高血压前期”(血压在120/80和139/89 mmHg之间)。这两种情况都会影响很大一部分人群。有证据表明,高正常血压与不良风险状况和心血管事件风险增加有关。因此,建议这类患者改变生活方式,一些试验数据表明,药物治疗可能对血压正常偏高的高危患者有益。然而,关于治疗干预对这一群体的益处的有力证据仍然缺乏。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A patient with high normal blood pressure--should we treat?
Currently blood pressure (BP) is considered normal (for most subjects) if below 140 mmHg for systolic and 90 mmHg for diastolic BP. However, the risk of death displays an approximately linear relationship with BP levels below this cut‐off. Therefore more attention is now being paid to the portion of the population characterized by BP levels remaining within normal limits but approaching the 140/90 mmHg level. The 2003 ESH–ESC guidelines define BP between 130/85 and 139/89 mmHg as “high normal”, while the 2003 JNC7 guidelines introduced a new category of “prehypertension” (BP between 120/80 and 139/89 mmHg). Both these conditions affect a significant portion of a general population. Evidence is available that high normal BP is associated with an adverse risk profile and an increased risk of cardiovascular events. Therefore lifestyle changes are recommended in subjects belonging to this category and some trial data indicate that pharmacological treatment may be beneficial in high‐risk subjects with high normal BP levels. Strong evidence on the benefits of therapeutic intervention in this group is, however, still lacking.
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