2015 年高压管理指南.docVIP

2015 年高血压管理指南（以下简称新指南） 东亚国家（中国、日本、韩国）高血压导致的卒中风险 高于冠心病。收缩压同样升高 15mmHg，亚洲人冠心病和卒中的风险增加高于 高加索人，反之，血压降低带来的卒中风险降低也高于西方国家。提示控制血 压是降低亚洲国家心脑血管事件（尤其是卒中）最重要的策略。 新指南建议，白大衣高血压患者应 开始生活方式调整，定期复查 ABPM 或行 HBPM，以尽早发现进展为持续高血 压的证据。 夜间血压均值较白天血压均值对预后的意义更大。 强调家庭血压监测（HBPM）和动态血压监测（ABPM）的重要性，以 便更好地检出夜间高血压、晨起高血压、白大衣高血压和隐性高血压 生活方式调整是所有高血压治疗的基础，包括 S-ABCDE（限盐、限 酒、减轻体重、戒烟、饮食、锻炼）几方面。 药物治疗则采用 PROCEED 策略（既往治疗经验、危险因素、器官损害、 禁忌证、专家或医生的判断、费用和治疗依从性）。对降压药物疗效的判断， 遵循“10 和 5 原则”，即单药标准剂量可降低收缩压 10mmHg，降低舒张压 5mmHg。同一药物剂量加倍，血压仅再降低 2/1mmHg，而联合不同机制的降 压药物，降压幅度是二者的总和（20/10mmHg）；推荐早期联合治疗，特别是 单片固定复方制剂；⑤初始治疗血压未达标时推荐“AT GOALs”方法调整治疗 （依从性、给药时间、增加剂量、换用其他种类降压药物、联合用药以及实验 室检查评估） village temples Central Office every day, carry out their duties. Correspondence relating to education by the Chief of the first section marked my draft statement. Worked after a few months, Ive been buried in the official program, very rigid monotony of clerical career, flavourless. 1939 of 7 August between, County, and Secretary to I with to Office meeting, for Government established one years to work reported, for time rush, prior not for full prepared, had to in way by rank Ann Mr described one years to about people, and fiscal, and built, and taught, and insurance five aspects important matters, I accordingly detailed narrative finishing written, completed Wujiang Government established one years to of work report. Turn back and forth month Shan Road, apart from the Secretary, Mr rank foot disease immobility, bamboo car instead of walking outside, square foot (except for myself and 4 guards), the wuxing, peace, SI an, Guangde, doorway swing, Zhang Zhu to the destination--wearing Bu. At diwei to the important towns of troops is difficult to access, we have to change angles, Shan rugged trails, Sun and rain on the way, hardship exceptions, if the patriotic and passions of the war, than the successful completion of tasks. An old frail, rank, long-distance Lawton regrets, admirable! In November 1939, I was admitted to the Faculty o