Laffin Luke J, Bakris George L
Department of Medicine, ASH Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, IL, USA.
Curr Cardiol Rep. 2015 Jun;17(6):37. doi: 10.1007/s11886-015-0591-y.
The most recent guideline statements by the 2014 Expert Panel of the National Institutes of Health as well as the American and International Societies of Hypertension recommend a blood pressure goal of <140/90 mmHg in patients with diabetes mellitus. This follows prior guidelines that recommended lower BP treatment goals of <130/80 mmHg in patients with diabetes. Reducing cardiovascular morbidity and mortality by trying to achieve recommended goals of risk factors like blood pressure, glucose, and cholesterol in patients with diabetes is paramount. Data from multiple trials demonstrates that early treatment of hypertension in people with diabetes clearly prevents both macrovascular and microvascular complications, but the goal blood pressure that should be achieved is now modified to a higher level. We address the evidence and evolution of how and why this blood pressure goal has changed in recent years.
美国国立卫生研究院2014年专家小组以及美国和国际高血压学会发布的最新指南声明建议，糖尿病患者的血压目标为<140/90 mmHg。此前的指南曾建议糖尿病患者的血压治疗目标更低，为<130/80 mmHg。通过努力实现糖尿病患者血压、血糖和胆固醇等危险因素的推荐目标来降低心血管发病率和死亡率至关重要。多项试验的数据表明，糖尿病患者早期治疗高血压显然可预防大血管和微血管并发症，但目前应达到的目标血压已调整为更高水平。我们阐述了近年来这一血压目标如何以及为何发生变化的证据和演变情况。
