Sowers J R
Division of Endocrinology, Metabolism, and Hypertension, Wayne State University School of Medicine, Detroit, Michigan, USA.
Clin Cornerstone. 1999;2(1):1-12. doi: 10.1016/s1098-3597(99)90078-9.
General recommendations from US and international organizations indicate that an ideal approach to the therapy of hypertension should begin with lifestyle modifications, such as decreased salt and fat intake and a careful aerobic exercise program, with the therapeutic goal of a blood pressure (BP) < 140/90 mm Hg. The most recent guidelines recommend more rigorous targets for BP lowering in high-risk populations, such as those with hypertension and concomitant diabetes and/or renal disease with proteinuria. This chapter addresses hypertension in patients with diabetes as an example of a group at especially high risk. It reviews recent clinical trials that support more rigorous BP goals in such patients to reduce cardiovascular morbidity and mortality and considers the importance of combination therapy in achieving these goals.
美国和国际组织的一般建议表明，高血压治疗的理想方法应从生活方式改变开始，如减少盐和脂肪摄入以及进行精心安排的有氧运动计划，治疗目标是血压（BP）<140/90 mmHg。最新指南建议对高危人群，如患有高血压并伴有糖尿病和/或伴有蛋白尿的肾病患者，设定更严格的血压降低目标。本章以糖尿病患者的高血压为例，探讨这一特别高危群体的情况。它回顾了近期的临床试验，这些试验支持对此类患者设定更严格的血压目标以降低心血管发病率和死亡率，并考虑联合治疗在实现这些目标中的重要性。
