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降压目标之争：SPRINT是终结者吗？ 被引量：1

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摘要 血压目标水平的争议由来已久.尽管近期众多高血压指南建议将多数高血压患者的收缩压控制在140 mmHg（1 mmHg =0.133 kPa）以下,但其证据并不充分.美国2014成人高血压管理循证指南（俗称JNC 8）推荐60岁以下普通人群以及糖尿病、慢性肾病等患者收缩压应控制在140 mmHg以下,但其证据级别仅为E级,即专家共识性意见[1-2].相比之下,指南推荐将舒张压控制在90 mmHg以下的证据要充分些.早期开展的一些随机对照临床试验（RCT）,如医学研究理事会试验（MRC）、退伍军人管理系统协作试验等发现,舒张压降至90 mmHg以下,可明显减少主要血管事件[1].
作者 刘靖
机构地区 北京大学人民医院心脏中心
出处 《中华心血管病杂志》 CAS CSCD 北大核心 2016年第3期191-193,共3页 Chinese Journal of Cardiology
关键词 降压目标 随机对照临床试验 高血压患者 高血压指南 证据级别 高血压管理 目标水平 循证指南
分类号 R544.1 [医药卫生—心血管疾病]
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参考文献9

  • 1JamesPA, OparilS, CarterBL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)[J]. JAMA, 2014,311(5):507–520.DOI: 10.1001/jama.2013.284427.
  • 2刘靖.“美国高血压预防、检测、评估与治疗联合委员会第8次报告”解析[J].中华高血压杂志,2014,22(3):218-221. 被引量：6
  • 3HanssonL, ZanchettiA, CarruthersSG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group[J]. Lancet, 1998,351(9118):1755–1762.
  • 4Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group[J]. BMJ, 1998,317(7160):703–713.
  • 5CushmanWC, EvansGW, ByingtonRP, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus[J]. N Engl J Med, 2010,362(17):1575–1585.DOI: 10.1056/NEJMoa1001286.
  • 6刘靖.对近期国际高血压指南的评价与思考[J].慢性病学杂志,2015,15(1):3-5. 被引量：2
  • 7WrightJT, WilliamsonJD, WheltonPK, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control[J]. N Engl J Med, 2015, 373(22): 2103–2116. DOI:10.1056/NEJMoa1511939.
  • 8PatelA, ADVANCE Collaborative Group, MacMahonS,et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes inpatients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial.Lancet, 2007, 370(9590): 829–840. DOI: http://dx.doi.org/10.1016/S0140–6736(07)61303–8.
  • 9XieX, AtkinsE, LvJ, et al. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis[J]. Lancet, 2016, 387:435–443. DOI:10.1016/S0140–6736(15)00805–3.

二级参考文献7

  • 1Alan S. Go,Mary Ann Bauman,Sallyann M. Coleman King,Gregg C. Fonarow,Willie Lawrence,Kim A. Williams,Eduardo Sanchez.An Effective Approach to High Blood Pressure Control: A Science Advisory From the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention[J]. Hypertension . 2014 (4)
  • 2Giuseppe Mancia,Robert Fagard,Krzysztof Narkiewicz,Josep Redon,Alberto Zanchetti,Michael B?hm,Thierry Christiaens,Renata Cifkova,Guy De Backer,Anna Dominiczak,Maurizio Galderisi,Diederick E. Grobbee,Tiny Jaarsma,Paulus Kirchhof,Sverre E. Kjeldsen,Stéphane Laurent,Athanasios J. Manolis,Peter M. Nilsson,Luis Miguel Ruilope,Roland E. Schmieder,Per Anton Sirnes,Peter Sleight,Margus Viigimaa,Bernard Waeber,Faiez Zannad,Josep Redon,Anna Dominiczak,Krzysztof Narkiewicz,Peter M. Nilsson.2013 ESH/ESC Guidelines for the management of arterial hypertension[J]. European Heart Journal . 2013 (28)
  • 3Chobanian Aram V,Bakris George L,Black Henry R,Cushman William C,Green Lee A,Izzo Joseph L,Jones Daniel W,Materson Barry J,Oparil Suzanne,Wright Jackson T,Roccella Edward J.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA : the journal of the American Medical Association . 2003
  • 4Jarnes PA,Oparil S,Carter BL,et al.2014 evidence-based guideline for the management of high blood pressure in adults report from the panel members appointed to the Eighth Joint National Committee (JNC 8). The Journal of The American Medical Association . 2014
  • 5WEBER M A,SCHIFFRIN E L,WHITE W B,et al.Clinical practice guidelines for the management of hypertension in the community:a statement by the american society of hypertension and the international society of hypertension. Journal of Clinical Hypertension . 2014
  • 6刘靖.2013《美国心脏协会/美国心脏病学会/美国疾病控制与预防中心高血压控制有效路径的科学建议》解读与启示[J].中华高血压杂志,2013,21(12):1101-1104. 被引量：5
  • 7刘靖.“美国高血压预防、检测、评估与治疗联合委员会第8次报告”解析[J].中华高血压杂志,2014,22(3):218-221. 被引量：6

共引文献6

同被引文献13

引证文献1

二级引证文献89

中华心血管病杂志
2016年 第3期

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