对糖尿病患者的血压进行最佳控制可降低大血管和微血管事件的发生率。

Giuseppe Mancia
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引用次数: 30

摘要

在糖尿病患者中,高血压是心血管和肾脏事件的重要危险因素,包括大血管和微血管并发症,如肾病。无论治疗方案如何,当血压降低时,风险就会降低,并且发现强化治疗方案比低强度治疗方案提供更大的保护。将收缩压(SBP)和舒张压降至低于130/80 mmHg的值提供了最有希望的保护程度,血压高于这些值或至少在正常血压高(>或= 130/85 mmHg)范围内的糖尿病患者应开始降压治疗。然而,临床试验未能使收缩压低于130毫米汞柱,糖尿病患者的血压控制率仅为非糖尿病患者的一半,通常难以达到这一目标。联合降压治疗优于更传统的策略,现在被认为是实现糖尿病和高血压患者快速血压控制的必要手段。最近的数据表明,血压控制比以前认为的要复杂得多。由于生物节律、血压测量方法和中央与周围血压的变化,个体的血压会随时间而变化;因此,在解释血压结果时需要考虑这些因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimal control of blood pressure in patients with diabetes reduces the incidence of macro and microvascular events.

In patients with diabetes mellitus, hypertension is an important risk factor for cardiovascular and renal events, including macro and microvascular complications such as nephropathy. The risks are reduced when blood pressure is decreased, regardless of the treatment regimen, and intensive regimens have been found to offer greater protection than less intensive regimens. Reducing systolic blood pressure (SBP) and diastolic blood pressure to values less than 130/80 mmHg offers the most promising degree of protection, and antihypertensive therapy should be started in patients with diabetes with blood pressure greater than these values or at least in the high normal (>or= 130/85 mmHg) blood pressure range. This target lower blood pressure has typically been difficult to obtain, however, with clinical trials failing to achieve an SBP of less than 130 mmHg and blood pressure control rates in patients with diabetes only half those observed in those without diabetes. Combination antihypertensive therapy is superior to more conventional strategies, and is now considered necessary to achieve rapid blood pressure control in patients with diabetes and hypertension. Recent data have indicated that blood pressure control is more complex than previously believed. An individual's blood pressure can vary over time as a result of variations in biorhythms, methods of blood pressure measurement and central versus peripheral blood pressure; these factors therefore need to be taken into consideration when interpreting blood pressure results.

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