Fixen Cy W, Saseen Joseph J, Vande Griend Joseph P, Linnebur Sunny A
Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and Department of Family Medicine, School of Medicine, Aurora, CO, USA.
Ther Adv Cardiovasc Dis. 2016 Apr;10(2):67-73. doi: 10.1177/1753944715621000. Epub 2015 Dec 16.
In late 2013, the Joint National Committee (JNC 8) published hypertension treatment recommendations endorsing a goal blood pressure (BP) of < 150/90 mmHg starting at age 60 years. This was in contrast to other cardiovascular groups recommending age 80 years for this BP goal. This study examined mean BP in patients from age 60 years to 79 years with hypertension before and after publication of the JNC 8 recommendations.
This retrospective cohort study examined mean BP and number of antihypertensives for a period of 1 year before and after the release of the JNC 8 report. Patients aged 60-79 years with hypertension receiving care at a University of Colorado Hospital primary care clinic were included. Patients with diabetes, chronic kidney disease, or kidney transplant were excluded. A total of 150 BP measurements were included in each of the before and after time frames. The primary outcomes were change in mean BP and number of antihypertensives.
A total of 171 patients met the criteria and were included in the study. Most had BPs in both the before and after time frames. Mean BP values were similar in the before and after groups (130.2/75.9 mmHg versus 131.5/76.6, respectively; p = 0.27/p = 0.46). Mean number of antihypertensives were similar in the before and after groups (1.95 versus 1.93, respectively; p = 0.79).
Over 1 year at an academic health system, new recommendations from the JNC 8 did not affect mean BP or number of antihypertensives in older patients with hypertension. A similar investigation after more time or in patients with newly diagnosed hypertension may help determine the full impact.
2013年末，美国国家联合委员会（JNC 8）发布了高血压治疗建议，认可60岁起的目标血压（BP）<150/90 mmHg。这与其他心血管组织建议的80岁设定该血压目标形成对比。本研究调查了JNC 8建议发布前后60至79岁高血压患者的平均血压。
这项回顾性队列研究调查了JNC 8报告发布前后1年的平均血压和抗高血压药物数量。纳入在科罗拉多大学医院初级保健诊所接受治疗的60 - 79岁高血压患者。排除患有糖尿病、慢性肾病或肾移植的患者。前后两个时间段各纳入150次血压测量值。主要结局为平均血压和抗高血压药物数量的变化。
共有171名患者符合标准并纳入研究。大多数患者在前后两个时间段均有血压测量值。前后两组的平均血压值相似（分别为130.2/75.9 mmHg和131.5/76.6 mmHg；p = 0.27/p = 0.46）。前后两组的抗高血压药物平均数量相似（分别为1.95和1.93；p = 0.79）。
在一个学术健康系统中，经过1年时间，JNC 8的新建议并未影响老年高血压患者的平均血压或抗高血压药物数量。在更长时间后或对新诊断高血压患者进行类似调查可能有助于确定其全面影响。
