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对美国心脏协会和欧洲心脏病学会高血压指南的批判性分析

Critical analysis of American heart association and European society of cardiology guidelines for hypertension.

作者信息

Sorte Akshayata G, Turankar Tileshkumar B, Sawale Shantanu, Acharya Sourya, Shukla Samarth

机构信息

Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.

Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.

出版信息

J Family Med Prim Care. 2023 Aug;12(8):1505-1510. doi: 10.4103/jfmpc.jfmpc_2125_22. Epub 2023 Aug 29.

Abstract

This study places more of an emphasis on the hypertensive guidelines that are recommended for the management of hypertension by the American College of Cardiology (ACC) and the American Heart Association (AHA), as well as the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). This study examines the development of several different guidelines and focuses primarily on contrasting the similarities and differences that are given by American and European guidelines. Both sets of recommendations encourage the use of an optimal method for measuring blood pressure, such as the use of home blood pressure (BP) monitoring, or ambulatory monitoring, which a key recommendation is given by both sets of recommendations for the primary prevention of hypertension, and non-pharmacological treatment, such as modifying one's lifestyle, as the primary intervention. There are some differences between American and European BP treatment guidelines when it comes to determining what constitutes high BP and determining what BP level should serve as the treatment goal. To start pharmacological therapy, the AHA and ACC suggest maintaining a BP of at least 130/80 mmHg with an ASCVD positive or a cardiovascular risk of more than 10%, but the ESH and ESC propose maintaining a BP of at least 140-159/90-99 mmHg. Following American rules, high BP is divided into two stages; however, according to European recommendations, it is divided into three stages. Both sets of recommendations strongly encourage the use of combination therapies that only require one pill, such as single-pill treatment for multiple conditions, and both sets of recommendations restrict the use of certain drugs, such as beta-blockers, to patients who also have additional medical conditions.

摘要

本研究更侧重于美国心脏病学会(ACC)和美国心脏协会(AHA)以及欧洲心脏病学会(ESC)和欧洲高血压学会(ESH)推荐的高血压管理指南。本研究考察了几种不同指南的制定情况,并主要聚焦于对比美国和欧洲指南的异同。两组建议都鼓励采用最佳血压测量方法,如使用家庭血压(BP)监测或动态血压监测,这是两组建议针对高血压一级预防的关键建议,同时也鼓励将非药物治疗,如改变生活方式,作为主要干预措施。在确定什么构成高血压以及确定应将何种血压水平作为治疗目标方面,美国和欧洲的血压治疗指南存在一些差异。开始药物治疗时,AHA和ACC建议,对于动脉粥样硬化性心血管疾病(ASCVD)呈阳性或心血管风险超过10%的患者,应将血压维持在至少130/80 mmHg,但ESH和ESC则建议维持在至少140 - 159/90 - 99 mmHg。按照美国的标准,高血压分为两个阶段;然而,根据欧洲的建议,它分为三个阶段。两组建议都强烈鼓励使用只需服用一片药的联合疗法,如针对多种病症的单片治疗,并且两组建议都限制某些药物,如β受体阻滞剂,仅用于患有其他病症的患者。

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本文引用的文献

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Resistant hypertension.顽固性高血压
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