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    《2014年成人高血壓管理指南（JNC8）》簡(jiǎn)介：
 

    （1）60歲以上人群的目標血壓為150/90mmHg,60歲以下人群目標值為140/90mmHg,包括糖尿病和腎臟病患者。

    （2）噻嗪類(lèi)利尿劑、CCB、ACEI和ARB四大類(lèi)藥物作為初始治療藥物（一線(xiàn)治療藥物，黑人僅利尿劑與CCB），可單獨或聯(lián)合使用；β受體阻滯劑退出一線(xiàn)，降至四線(xiàn)，與螺內酯同等地位。

    （3）新指南強調了達標和維持目標（長(cháng)期達標）[The main objective of hypertension treatment is to attain and maintain goal BP].

    （4）新指南不是那么強烈推薦起始聯(lián)合了[Some committee members recommend],而是“起始單藥再單藥加量”、“起始單藥再加第二種”、“起始兩種聯(lián)合”三種策略都可以。

    （5）腎病患者首選RAS阻斷劑；糖尿病患者沒(méi)有優(yōu)先推薦RAS阻斷劑，而是四種都可以；CCB減少卒中優(yōu)于A(yíng)CEI（中國的主要問(wèn)題是卒中）。

    《2014年成人高血壓管理指南（JNC8）》內容預覽：

    Hypertension is the most common condition seen in primary care and leads to myocardialinfarction, stroke, renal failure, and death if not detected early and treated appropriately.Patients want to be assured that blood pressure (BP) treatment will reduce their diseaseburden, while clinicians want guidance on hypertension management using the best scientificevidence. This report takes a rigorous, evidence-based approach to recommend treatmentthresholds, goals, and medications in the management of hypertension in **s. Evidencewas drawn from randomized controlled trials, which represent the gold standard fordetermining efficacy and effectiveness. Evidence quality and recommendations were gradedbased on their effect on important outcomes.


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