Wermelt J A, Schunkert H
Klinik für Herz- und Kreislauferkrankungen, Technische Universität München, Deutsches Herzzentrum München, Lazarettstraße 36, 80636, München, Deutschland.
Herz. 2017 Aug;42(5):515-526. doi: 10.1007/s00059-017-4574-1.
Arterial hypertension has a high prevalence and is a major risk factor for the development of cardiovascular diseases. It is a major contributor to worldwide morbidity and mortality and hence poses a huge socioeconomic burden. Despite great progress in perception, diagnosis and treatment of hypertension, blood pressure control is inadequate in less than half of the hypertensive patients (<140/90 mm Hg). The diagnosis of arterial hypertension starts in most patients with the conventional office blood pressure measurement. Out-of-office blood pressure measurement is an important adjunct, especially to unmask white-coat hypertension. To reach the right target blood pressure many effective antihypertensive drugs are available. By how much the blood pressure should be lowered is currently a matter of controversy. The 2013 European and the identical German national guidelines recommend a target blood pressure of <140/90 mm Hg for most patients. The recent SPRINT study revealed that some patients may benefit from an even lower blood pressure. This CME-article summarizes recent developments in the management of arterial hypertension and provides tips for daily practice based on these aims.
动脉高血压患病率高，是心血管疾病发生的主要危险因素。它是全球发病和死亡的主要原因，因此带来了巨大的社会经济负担。尽管在高血压的认识、诊断和治疗方面取得了很大进展，但仍有不到一半的高血压患者血压控制不佳（<140/90 mmHg）。大多数患者动脉高血压的诊断始于常规诊室血压测量。诊室外血压测量是一项重要辅助手段，尤其有助于识别白大衣高血压。为达到正确的血压目标，有许多有效的抗高血压药物可供使用。目前，血压应降低多少存在争议。2013年欧洲及德国相同的国家指南建议大多数患者的血压目标为<140/90 mmHg。最近的SPRINT研究表明，一些患者可能从更低的血压中获益。这篇继续医学教育文章总结了动脉高血压管理的最新进展，并基于这些目标为日常实践提供了建议。
