Egan Brent M, Bland Veita J, Brown Angela L, Ferdinand Keith C, Hernandez German T, Jamerson Kenneth A, Johnson Wallace R, Kountz David S, Li Jiexiang, Osei Kwame, Reed James W, Saunders Elijah
Board of Trustees, International Society of Hypertension in Blacks (ISHIB), Arlington, VA; Care Coordination Institute, University of South Carolina School of Medicine, Greenville, SC.
J Clin Hypertens (Greenwich). 2015 Apr;17(4):252-9. doi: 10.1111/jch.12511. Epub 2015 Mar 10.
A 2014 hypertension guideline raised goal systolic blood pressure (SBP) from <140 mm Hg to <150 mm Hg for adults 60 years and older without diabetes mellitus (DM) or chronic kidney disease (CKD). The authors aimed to define the status of hypertension in black adults 60 to 79 years from the National Health and Nutrition Examination Survey 2005-2012 and provide practical guidance. Black patients were more often aware and treated (P≤.005) for hypertension than whites and had higher rates of DM/CKD (P<.001), similar control to <140/<90 mm Hg with DM/CKD (P=.59), and lower control without DM/CKD (<140/<90 mm Hg and <150/<90 mm Hg, P≤.01). Limited awareness (<30%) and infrequent health care (>30% 0-1 health-care visits per year) occurred in untreated black and white hypertensive patients without DM/CKD and BP ≥140/<90 mm Hg. The literature suggests benefits of treated SBP <140 mm Hg in adults 60 to 79 years without DM/CKD. The International Society of Hypertension in Blacks recommends: (1) continuing efforts to achieve BP <140/<90 mm Hg in those with DM/CK, and (2) identifying hypertensive patients without DM/CKD and BP ≥140/<90 mm Hg and treat to an SBP <140 mm Hg in black adults 60-79 years.
2014年的一项高血压指南将60岁及以上无糖尿病（DM）或慢性肾脏病（CKD）的成年人的收缩压目标值从<140 mmHg提高到了<150 mmHg。作者旨在根据2005 - 2012年美国国家健康和营养检查调查确定60至79岁黑人成年人的高血压状况，并提供实用指导。黑人患者比白人更常知晓并接受高血压治疗（P≤0.005），且糖尿病/慢性肾脏病发病率更高（P<0.001），在患有糖尿病/慢性肾脏病的患者中，血压控制在<140/<90 mmHg的比例相似（P = 0.59），而在无糖尿病/慢性肾脏病的患者中控制率较低（<140/<90 mmHg和<150/<90 mmHg，P≤0.01）。在未治疗的无糖尿病/慢性肾脏病且血压≥140/<90 mmHg的黑人和白人高血压患者中，存在知晓率低（<30%）和医疗保健不频繁（>30%每年0 - 1次医疗就诊）的情况。文献表明，在60至79岁无糖尿病/慢性肾脏病的成年人中，收缩压治疗至<140 mmHg有益。黑人高血压国际协会建议：（1）继续努力使患有糖尿病/慢性肾脏病的患者血压达到<140/<90 mmHg；（2）识别无糖尿病/慢性肾脏病且血压≥140/<90 mmHg的高血压患者，并将60 - 79岁黑人成年人的收缩压治疗至<140 mmHg。
