Division of General Internal Medicine, McGill University, Montreal, Québec, Canada.
Can J Cardiol. 2012 May;28(3):270-87. doi: 10.1016/j.cjca.2012.02.018.
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to < 140/90 mm Hg from < 130/80 mm Hg. We also reviewed the recent evidence on blood pressure targets for patients with hypertension and diabetes and continue to recommend a blood pressure target of less than 130/80 mm Hg.
我们更新了 2012 年成人高血压诊断、评估、预防和治疗的循证推荐。新的推荐包括:(1) 使用家庭血压监测来确认白大衣综合征的诊断;(2) 盐皮质激素受体拮抗剂可用于特定高血压伴收缩性心力衰竭患者;(3) 高血压伴心房颤动史不应成为决定开血管紧张素受体阻滞剂治疗高血压的因素;(4) 非糖尿病慢性肾脏病患者的血压目标现在已从<130/80mmHg 改为<140/90mmHg。我们还回顾了高血压合并糖尿病患者血压目标的最新证据,仍建议血压目标<130/80mmHg。