Interpretation of the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension

doi:10.12114/j.issn.1007-9572.2019.00.224

Abstract

Abstract: As the concept of prevention and treatment of cardiovascular diseases has gradually transferred from passive prevention to active prevention，hypertension，a primary risk factor for cardiovascular diseases，has been receiving more and more attention.The 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension released at the 2018 European Society of Cardiology Congress was based on recent clinical evidence of the benefits of anti-hypertension treatment for cardiovascular diseases.Compared with the 2013 version，hypertension management and control have been significantly updated in the new guidelines，but some previous ideas are still being followed.The new guidelines comprehensively and detailedly elaborates the hypertension diagnosis，blood pressure measurement，risk stratification of hypertension，initiation of antihypertensive treatment，blood pressure treatment targets，hypertension treatment，and management of resistant and secondary hypertension，with efforts intensified in the prevention and control，in particular，the initiation time and threshold value for blood pressure-lowering drug treatment and initiation of drug combination.Besides，priority recommendation of single tablet regimen of fixed compound preparations，and concepts of blood pressure monitoring and comprehensive management in patients with hypertension，are also worthy of clinical reference and learning.

Key words: Hypertension, Guidebooks, General practitioners, Blood pressure measurement, Antihypertensive therapy

摘要： 随着心血管病的防治理念逐渐由被动防治转向主动预防，高血压作为心血管病的首要危险因素，也越来越受到重视，近年来有关降压治疗带来心血管病获益的临床循证医学证据不断积累，2018年欧洲心脏病学会年会上发布的《2018年欧洲高血压管理指南》，较《2013年欧洲高血压管理指南》在高血压的管控方面有较大更新，既沿用了以往的一些理念，又更新了许多新的内容，新版高血压管理指南在高血压诊断、血压测量、高血压的风险分层、降压治疗的启动时机、降压治疗的目标值变化、高血压的治疗、难治性高血压与继发性高血压的处理等方面均进行了全面而详细的阐述，其在高血压防控方面加大了力度，尤其在高血压的启动治疗时机、启动治疗的血压阈值、治疗药物的起始联合用药及对单片固定复方制剂的优先推荐以及高血压患者的血压监测及综合管理的治疗理念方面，值得临床借鉴与学习。

关键词: 高血压, 指南, 全科医生, 血压测量, 降压治疗

CHENG Wenli. Interpretation of the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension　[J]. Chinese General Practice, 2019, 22(21): 2519-2523. DOI: 10.12114/j.issn.1007-9572.2019.00.224.
程文立. 《2018年欧洲高血压管理指南》解读[J]. 中国全科医学, 2019, 22(21): 2519-2523. DOI: 10.12114/j.issn.1007-9572.2019.00.224.

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