jnc8涉及药物的解读概要1.pptxVIP

讨论 JNC8涉及的药物 TO DISCUSS 注释1 Joint National Committee (JNC 8) hypertension guidelines 与JNC7的对比 注释2 JNC8诊治流程 注释2 注释 JNC8关于降压药物的建议一 建议6 在一般的非黑色人种，包括那些患有糖尿病的高血压患者，初始降压治疗应包括噻嗪类利尿剂，钙离子通道阻滞剂（CCB），血管紧张素转换酶抑制剂（ACEI）或血管紧张素受体拮抗剂（ARB）。 ——（中度建议 - B级） Recommendation 6 In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic, cal- cium channel blocker (CCB), angiotens in-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). (Moderate Recommenda- tion – Grade B) JNC8关于降压药物的建议二 建议7 在一般的黑色人种，包括那些患有糖尿病的患者，初始抗高血压治疗应包括噻嗪类利尿剂或CCB。 ——（对于一般的黑人患者：中等建议 -B级 黑人糖尿病患者：弱推荐 - C级） Recommendation 7 In the general black population, including those with diabetes, initial anti- Hypertensive treatment should include a thiazide-type diuretic or CCB. (For general black population: Moderate Recommendation –Grade B; for black patients with diabetes: Weak Recommendation – Grade C) JNC8关于降压药物的建议三 建议8 在大于18岁的慢性肾病患者，初始（或附加）降压治疗应包括ACEI或ARB以改善肾脏的结果。不区分种族或糖尿病状态，这适用于所有合并慢性肾病的高血压患者。 ——（中度建议，B级） Recommendation 8 In the population aged 18 years with CKD, initial (or add-on)antihyper- tensive treatment should include an ACEI or ARB to improve kidney out- comes. This applies to all CKD patients with hypertension regardless ofrace or diabetes status. (Moderate Recommendation –Grade B) （中度建议 - B级） “ 观点：关于推荐6的水平 (Moderate Recommendation – Grade B) 延伸阅读： 关于此项建议，指南原文给出的理由是什么？ For this recommendation, only RCTs that compared one class of anti hypertensive medication to another and assessed the effects on health outcomes were reviewed; placebo-controlled RCTs were not included. However, the evidence review was informed by major placebo-controlled hypertension trials, including 3 federally funded trials (VA Cooperative Trial , HDFP, and SHEP), that were pivotal in demonstrating that treatment of hypertension with antihypertensive medications reduces cardiovascular or cerebrovascular events and/or mortality. 3,13,