Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C).
Department of Medicine, Case-Western Reserve University School of Medicine, Cleveland, OH (J.T.W.).
Circ Res. 2021 Apr 2;128(7):827-846. doi: 10.1161/CIRCRESAHA.121.318083. Epub 2021 Apr 1.
Several important findings bearing on the prevention, detection, and management of hypertension have been reported since publication of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. This review summarizes and places in context the results of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics covered include blood pressure measurement, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and blood pressure threshold for drug therapy, lifestyle and pharmacological management, treatment target blood pressure goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches. Presenting new information in each of these areas has the potential to increase hypertension awareness, treatment, and control which remain essential for the prevention of cardiovascular disease and mortality in the future.
自 2017 年美国心脏病学会/美国心脏协会血压指南发布以来,已经有几项关于高血压预防、检测和管理的重要研究结果报告。这篇综述总结并阐述了 2018 年 1 月至 2021 年 3 月期间发表的相关观察性研究、随机临床试验和荟萃分析的结果。涵盖的主题包括血压测量、继发性高血压患者评估、心血管疾病风险评估和药物治疗血压阈值、生活方式和药物治疗管理、治疗目标血压目标、老年患者高血压管理、糖尿病、慢性肾脏病、耐药性高血压以及使用患者、提供者和医疗系统方法优化护理。在这些领域中的每一个领域都提出了新的信息,这有可能提高高血压的认识、治疗和控制水平,这对于未来预防心血管疾病和死亡率仍然至关重要。