Arch Intern Med. 1997 Nov 24;157(21):2413-46. doi: 10.1001/archinte.157.21.2413.
Racial and ethnic minority populations are growing segments of our society. The prevalence of hypertension in these populations differs across groups, and control rates are not as good as in the general population. Clinicians should be aware of these management challenges, taking social and cultural factors into account. Guidelines are provided for management of children and women with hypertension. In older persons, diuretics are preferred and long-acting dihydropyridine calcium antagonists may be considered. Specific therapy for patients with LVH, coronary artery disease, and heart failure are outlined. Patients with renal insufficiency with greater than 1 g/d of proteinuria should be treated to a therapy blood pressure goal of 125/75 mm Hg; those with less proteinuria should be treated to a blood pressure goal of 130/85 mm Hg. ACE inhibitors have additional renoprotective effects over other antihypertensive agents. Patients with diabetes should be treated to a therapy blood pressure goal of below 130/85 mm Hg. Hypertension may coexist with various other conditions and may be induced by various pressor agents.
种族和少数族裔人口在我们的社会中所占比例日益增加。这些人群中高血压的患病率因群体而异，且控制率不如普通人群。临床医生应意识到这些管理挑战，同时考虑社会和文化因素。本文提供了儿童和高血压女性的管理指南。对于老年人，首选利尿剂，也可考虑使用长效二氢吡啶类钙拮抗剂。概述了左心室肥厚、冠状动脉疾病和心力衰竭患者的具体治疗方法。蛋白尿大于1g/d的肾功能不全患者，治疗血压目标应为125/75mmHg；蛋白尿较少的患者，治疗血压目标应为130/85mmHg。与其他抗高血压药物相比，ACE抑制剂具有额外的肾脏保护作用。糖尿病患者的治疗血压目标应低于130/85mmHg。高血压可能与各种其他疾病共存，并可能由各种升压药物诱发。
