Morici M L, Di Marco A
Istituto di Clinica Medica, Università, Palermo.
Recenti Prog Med. 1994 Apr;85(4):246-56.
Despite the clear benefits of treating established hypertension, this approach alone will not prevent all of the blood pressure-related cardiovascular-renal disease in the community. Primary prevention of hypertension is a natural extension of hypertension treatment which provides opportunity to reduce costly cycle of managing hypertension and its complications. The purpose of this report is to guide practician physicians and health professionals in their care of hypertensive patients. In order to provide specific guidelines, a new classification schema of high blood pressure that includes systolic as well diastolic levels is proposed (source, Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure 1993). Furthermore, recommendations for follow-up based on initial set of blood pressure measurements, life-style modifications and pharmacologic therapy are proposed, suggesting a new treatment algorithm in which diuretics and beta-blockers are preferred as first-choice agents because their confirmed reduction in morbidity and mortality (unless they are contraindicated or unacceptable), but including an expanded list of agents that are suitable for initial monotherapy and guidelines for selecting and individualizing the antihypertensive drug regimen.
尽管治疗已确诊的高血压有明显益处,但仅靠这种方法并不能预防社区中所有与血压相关的心血管-肾脏疾病。高血压的一级预防是高血压治疗的自然延伸,它为减少管理高血压及其并发症的昂贵周期提供了机会。本报告的目的是指导执业医师和健康专业人员对高血压患者的护理。为了提供具体指南,提出了一种新的高血压分类方案,该方案包括收缩压和舒张压水平(来源:全国高血压检测、评估与治疗联合委员会,1993年)。此外,还提出了基于初始血压测量、生活方式改变和药物治疗的随访建议,提出了一种新的治疗算法,其中利尿剂和β受体阻滞剂作为首选药物,因为它们已被证实可降低发病率和死亡率(除非有禁忌或不可接受的情况),但包括一份适用于初始单药治疗的药物扩展清单以及选择和个体化抗高血压药物治疗方案的指南。