López-Jaramillo P, López-López J, Forero-Trillos M F, Rueda-Quijano S M, Camacho P A, Esmeral-Ordoñez D, Otero J
Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia; Universidad de Santander (UDES), Bucaramanga, Santander, Colombia; Facultad de Ciencias de la Salud Eugenio Espejo, UTE, Quito, Ecuador.
Universidad Autónoma de Bucaramanga, Floridablanca, Santander, Colombia.
Hipertens Riesgo Vasc. 2020 Jan-Mar;37(1):33-38. doi: 10.1016/j.hipert.2019.03.003. Epub 2019 Aug 7.
Given the fact that new guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) propose important changes in the definition of hypertension, from equal or greater than 140/90mmHg to equal or greater than 130/80mmHg, major debate has been generated about the diagnostic criteria and the treatment of high blood pressure (HBP). In addition, these guidelines recommend that in order to achieve control of hypertension the goal should be a reading lower than 130/80mmHg. These new figures will significantly increase the amount of individuals considered hypertensive, some of whom will need more medication to achieve the new goal. This paradigm has led to questioning the goal's clinical applicability given the enormous financial burden that would result from treating millions of new hypertensive patients. The academic validity of the AHA-ACC guidelines has also been questioned given the fact that the recommendations emerged basically from results obtained from a single study with important methodological differences compared to the majority of studies carried out previously. Furthermore, its outcomes are inconsistent with those of previous studies. This conflict has led to some scientific institutions, such as the Latin American Society of Hypertension (LASH), continuing to adhere to the previous recommendations.
鉴于美国心脏协会(AHA)和美国心脏病学会(ACC)的新指南提议对高血压的定义进行重大更改,从等于或大于140/90mmHg变为等于或大于130/80mmHg,关于高血压的诊断标准和治疗引发了重大争论。此外,这些指南建议,为了实现高血压的控制,目标血压应低于130/80mmHg。这些新数据将显著增加被视为高血压患者的数量,其中一些人将需要更多药物来实现新目标。鉴于治疗数百万新增高血压患者将带来巨大的经济负担,这种模式引发了对该目标临床适用性的质疑。鉴于AHA-ACC指南的建议基本上来自一项单一研究的结果,与之前进行的大多数研究相比存在重要的方法学差异,其学术有效性也受到了质疑。此外,其结果与之前的研究不一致。这种冲突导致一些科学机构,如拉丁美洲高血压学会(LASH),继续遵循之前的建议。