Ferdinand Keith C, Nasser Samar A
Division of Cardiology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA,
Curr Hypertens Rep. 2015 Mar;17(3):15. doi: 10.1007/s11906-014-0526-9.
Although several risk factors contribute to cardiovascular disease (CVD) overall, hypertension (HTN) is the major controllable risk factor. Hypertension is disproportionately more prevalent among Blacks or African-Americans compared with other race/ethnic populations, and the control rates among this disparate population are alarming. Several pathophysiologic mechanisms have been demonstrated and evaluated among hypertensives and the conglomeration of genetics, environmental, and personal lifestyle activities concurrently impact the progression of hypertension-related comorbidities (i.e., chronic renal disease, CVD, stroke, etc.). Specific pharmacotherapeutic choices are discussed and the most up-to-date data is presented to optimize the care of hypertensives. National and international guidelines for the treatment of HTN are reviewed and analyzed, presenting the most appropriate approach to the care of hypertensive patients overall. Additionally, national efforts supporting the goal of early HTN screening and treatment, as well as the variety of evidence-based pharmacotherapy, are summarized, applying to the public health impact overall.
虽然总体上有多种风险因素会导致心血管疾病（CVD），但高血压（HTN）是主要的可控风险因素。与其他种族/族裔人群相比，高血压在黑人或非裔美国人中更为普遍，且这一不同人群中的控制率令人担忧。在高血压患者中已经证实并评估了几种病理生理机制，并且遗传、环境和个人生活方式活动的综合作用同时影响高血压相关合并症（即慢性肾病、心血管疾病、中风等）的进展。文中讨论了具体的药物治疗选择，并提供了最新数据以优化高血压患者的护理。对国内和国际高血压治疗指南进行了回顾和分析，提出了总体上最适合高血压患者护理的方法。此外，总结了支持早期高血压筛查和治疗目标的国家努力以及各种循证药物治疗方法，这些努力和方法对整体公共卫生产生影响。
