2008年加拿大高血压教育计划高血压管理建议：第1部分——血压测量、诊断及风险评估
The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 - blood pressure measurement, diagnosis and assessment of risk.
作者信息
Padwal Raj S, Hemmelgarn Brenda R, Khan Nadia A, Grover Steven, McAlister Finlay A, McKay Donald W, Wilson Thomas, Penner Brian, Burgess Ellen, Bolli Peter, Hill Michael D, Mahon Jeff, Myers Martin G, Abbott Carl, Schiffrin Ernesto L, Honos George, Mann Karen, Tremblay Guy, Milot Alain, Cloutier Lyne, Chockalingam Arun, Rabkin Simon W, Dawes Martin Dawes, Touyz Rhian M, Bell Chaim, Burns Kevin D, Ruzicka Marcel, Campbell Norman R C, Lebel Marcel, Tobe Sheldon W
机构信息
Division of General Internal Medicine, University of Alberta, Edmonton, Canada.
出版信息
Can J Cardiol. 2008 Jun;24(6):455-63. doi: 10.1016/s0828-282x(08)70619-6.
OBJECTIVE
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.
OPTIONS AND OUTCOMES
The diagnosis of hypertension is dependent on appropriate blood pressure measurement, the timely assessment of serially elevated readings, degree of blood pressure elevation, method of measurement (office, ambulatory, home) and associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk and determine the urgency, intensity and type of treatment required.
EVIDENCE
MEDLINE searches were conducted from November 2006 to October 2007 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed, full-text articles only.
RECOMMENDATIONS
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Key messages in 2008 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of global risk assessment and the need for ongoing monitoring of hypertensive patients to identify incident type 2 diabetes.
VALIDATION
All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here received at least 70% consensus. These guidelines will continue to be updated annually.
目的
为成人高血压的诊断和评估提供最新的、基于证据的建议。
选项和结果
高血压的诊断取决于适当的血压测量、对连续升高读数的及时评估、血压升高程度、测量方法（诊室、动态、家庭）以及相关合并症。应确定心血管危险因素和靶器官损害的存在，以评估整体心血管风险，并确定所需治疗的紧迫性、强度和类型。
证据
在医学图书馆员的协助下，于2006年11月至2007年10月进行了MEDLINE检索。扫描参考文献列表，联系专家，并利用作者和亚组成员的个人档案来识别其他研究。内容和方法学专家使用预先指定的、标准化的基于证据的算法评估研究。建议仅基于同行评审的全文文章中的证据。
建议
概述了关于血压测量、高血压诊断和随访标准、整体心血管风险评估、诊断测试、高血压肾血管和内分泌病因的诊断、家庭和动态监测以及高血压患者使用超声心动图的建议。2008年的关键信息包括继续强调高血压的快速、准确诊断、整体风险评估的重要性以及对高血压患者进行持续监测以识别新发2型糖尿病的必要性。
验证
所有建议均根据证据强度进行分级，并由加拿大高血压教育计划基于证据的建议工作组的57名成员投票表决。此处报告的所有建议均获得至少70%的共识。这些指南将继续每年更新。
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