2007年高血压管理指南,从理论到实践:全球心血管风险概念。

Massimo Volpe, Giuliano Tocci
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引用次数: 41

摘要

高血压患者心血管风险的临床评估正在从独立评估众所周知的传统危险因素(如高血压、高胆固醇血症、肥胖、糖尿病、吸烟)发展为一种综合的、多学科的临床方法,旨在确定每个患者的整体(或全部)心血管风险概况,以便及早制定有效的心血管预防策略。高血压就是一个典型的例子,正如欧洲指南所强调的那样,新的临床行为意味着从只关注高血压水平转向更综合的方法,旨在识别和降低全球心血管风险。这种方法源于认识到心血管危险因素的集群是高血压的规则,而不是例外。此外,重大心血管疾病往往从亚临床阶段开始发展,可以在早期发现,从而为早期拦截和治疗高危患者提供了机会。器官损伤的识别和高血压相关临床状况的评估可以进一步有助于更精确地定义个体心血管总风险概况,并决定何时、如何和多少治疗高血压患者。实施基于全球心血管风险评估的临床行为将有助于降低全球心血管风险,同时保持针对个别风险因素的特定治疗目标。这种协同方法最有希望治疗心血管总风险,并减少与高血压相关的心血管疾病日益增加的全球负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
2007 ESH/ESC Guidelines for the management of hypertension, from theory to practice: global cardiovascular risk concept.

Clinical evaluation of cardiovascular risk in patients with hypertension is evolving from independently assessing well-known, traditional risk factors (e.g. hypertension, hypercholesterolemia, obesity, diabetes mellitus, smoking) towards an integrated, multidisciplinary clinical approach, aimed at determining the global (or total) cardiovascular risk profile in each individual patient for planning early and effective strategies for cardiovascular prevention. A paradigmatic example is provided by hypertension, in which new clinical behaviour implies a shift from focusing only on high blood pressure levels towards a more integrated approach, aimed at identifying and reducing global cardiovascular risk, as is highlighted in the European Guidelines. This approach arises from the acknowledgement that a cluster of cardiovascular risk factors is the rule, rather than the exception in hypertension. In addition, major cardiovascular diseases often develop from a subclinical level, which can be discovered at an early stage, thus providing the opportunity promptly to intercept and treat high-risk patients early. Identification of organ damage and assessment of hypertension-related clinical conditions can further contribute to a more precise definition of an individual total cardiovascular risk profile, and to the decision on when, how and how much to treat patients with hypertension. Implementing a clinical behaviour based on global cardiovascular risk assessment will help to target global cardiovascular risk reduction, while maintaining specific therapeutic goals for individual risk factors. This synergistic approach holds the best promise for treating total cardiovascular risk and reducing the mounting global burden of cardiovascular disease associated with hypertension.

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