University of Michigan, Ann Arbor, Michigan (J.B.B., R.D.B.).
Ann Intern Med. 2019 May 7;170(9):ITC65-ITC80. doi: 10.7326/AITC201905070.
Recent guidelines on diagnosis and management of high blood pressure (BP) include substantial changes and several new concepts compared with previous guidelines. These are reviewed and their clinical implications are discussed in this article. The goal is to provide a practical reference to assist clinicians with up-to-date management of patients with high BP. Important issues include new diagnostic thresholds, out-of-office BP monitoring, intensified treatment goals, and a different approach to resistant hypertension. Finally, differences among guidelines, the persistent controversies that have led to them, and their implications for clinical practice are discussed.
最近的高血压(BP)诊断和管理指南与以往的指南相比有了很大的变化和一些新概念。本文对这些指南进行了回顾,并讨论了其临床意义。目的是提供一个实用的参考,帮助临床医生对高血压患者进行最新的管理。重要的问题包括新的诊断阈值、诊室外血压监测、强化治疗目标以及对难治性高血压的不同处理方法。最后,讨论了指南之间的差异、导致这些差异的持续争议及其对临床实践的影响。