Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
Department of Medicine, Division of Cardiology, University of Mississippi Medical Center, Jackson, MS, USA.
Curr Hypertens Rep. 2020 Sep 2;22(10):75. doi: 10.1007/s11906-020-01086-6.
The purpose of this review is to describe the long-term or lifetime relationship between blood pressure and target organ damage. The use of the term "blood pressure" as opposed to hypertension is purposeful. The risk of cardiovascular disease from blood pressure begins below the levels of blood pressure defined as hypertension by contemporary definitions.
An important recent publication that bears on this topic was the 2017 ACC/AHA Blood Pressure Management Guidelines. The redefinition of hypertension and blood pressure treatment goal to 130/80 mmHg and the decision to rely almost exclusively on data from event-based randomized controlled clinical trials, which led to a recommendation for lifestyle therapy only for most with stage 1 hypertension, were important. A report from the CARDIA study demonstrated significant risk for cardiovascular disease at 20 years for stage 1 hypertension. Based on all evidence, clinicians should consider the use of medication for stage 1 hypertension in those uncontrolled on lifestyle therapy.
本综述旨在描述血压与靶器官损伤之间的长期或终身关系。使用“血压”而非“高血压”这一术语是有目的的。心血管疾病的风险源于血压，其起始水平低于当代定义的高血压所界定的血压水平。
与本主题相关的一项重要的最新出版物是 2017 年 ACC/AHA 血压管理指南。重新定义高血压和血压治疗目标为 130/80mmHg，并决定几乎完全依赖基于事件的随机对照临床试验的数据，这导致仅对大多数 1 期高血压患者推荐生活方式治疗，这一点很重要。CARDIA 研究的一份报告表明，1 期高血压患者在 20 年内发生心血管疾病的风险显著增加。基于所有证据，对于生活方式治疗控制不佳的 1 期高血压患者，临床医生应考虑使用药物治疗。
