Fudim Marat, Vemulapalli Sreekanth
Department of Cardiology, Duke University School of Medicine, 2301 Erwin Road, Durham, NC, USA.
Duke Clinical Research Institute, Durham, NC, USA.
Curr Hypertens Rep. 2016 Apr;18(4):26. doi: 10.1007/s11906-016-0640-y.
Untreated and uncontrolled hypertension (HTN) presents a major public health burden in the USA and worldwide. Despite the known risk for increased cardiovascular (CV) morbidity and mortality, blood pressure remains untreated and uncontrolled at alarming rates of between 20 and 40 % in patients with known HTN. Further, while cumulative evidence indicates that early onset of antihypertensive effect improves CV outcomes, the time to blood pressure (BP) control remains long. The objective of hypertension management cannot be simply to achieve and maintain the goal BP, but to do so quickly to improve short-term and long-term CV outcomes. In this review, we will (1) describe the magnitude of uncontrolled HTN, (2) identify the factors that contribute to uncontrolled BP in patients with the diagnosis of HTN, and (3) explore the rationale for and benefits of aggressive and immediate control of HTN.
未经治疗和控制的高血压在美国及全球都是一项重大的公共卫生负担。尽管已知高血压会增加心血管疾病的发病率和死亡率，但在已知患有高血压的患者中，血压仍未得到治疗和控制的比例高达20%至40%，令人担忧。此外，虽然累积证据表明抗高血压作用的早期起效可改善心血管结局，但实现血压控制的时间仍然很长。高血压管理的目标不能仅仅是达到并维持目标血压，而应迅速做到这一点，以改善短期和长期心血管结局。在本综述中，我们将：（1）描述未控制高血压的严重程度；（2）确定导致已诊断高血压患者血压未得到控制的因素；（3）探讨积极和立即控制高血压的基本原理及益处。
