高血压指南进展.ppt

2013年美国高血压学会年会（ASH） CCB ARB 内皮素受体拮抗剂 肾素抑制剂 CCB ARB 内皮素受体拮抗剂 肾素抑制剂 高血压治疗是过去这50年药物治疗取得最大的成功之一。 治疗方法的改善使降低每位患者的血压成为可能。 高血压仍是影响公共健康的主要问题，且发病率在不断增加，难以控制的高血压数量在不断增加，发病年龄越来越趋于年轻化。 Hypertension is an area of cardiovascular medicine in which evidence in favour of therapeutic intervention was searched for by randomized controlled intervention trials long before the same methodology was applied to the treatment of other cardiovascular illnesses, such as myo-cardial infarction and heart failure [2]. Despite this pio-neering approach, readers of this recent volume may be surprised to discover how scanty is the real evidence available on many issues of practical importance. ?Professor Alberto Zanchetti of Milan, Italy has been one of the most prominent researchers and teachers in the field of hypertension in Europe for the past 40 years /prime/thefaculty/member/4932874888007884 2007 ESH/ESC 实线：preferred combination 方框：beneficial in controlled intenvention trials 2013 ESH/ESC 绿色实线：preferred combination 绿色虚线：useful combinantion（with some limitaions） 黑色虚线：possible but less well tested comibination 红色实线：not recommended combination Nonetheless, now and in the foreseeable future, man-agement of hypertension will be based not only on evidence but also on wisdom. What is important, how-ever, is that wisdom is not taken as solid evidence: taking wisdom for evidence has been a powerful obstacle to clarification of some relevant issues of hypertension management by discouraging the design of adequate randomized trials. Among these orphan issues, probably the most important is investigating the optimal blood pressure target for antihypertensive treatment, particularly in high-risk patients, in whom a few mmHg lower blood pressure may markedly increase the benefit or the risk. 高血压药物治疗新展望 ASH 年会 、ESH/ESC 2013指南 2013年美国高血压学会年会（ASH） 2013欧洲高血压指南（ESH-ESC） 50年来，大量循证研究不断提高人们对高血压治疗的认识 1960s 1970s