高血压诊疗基础问题再探讨:血压测量、降压目标、降压策略

doi:10.3969/j.issn.1004-583X.2021.08.014

摘要/Abstract

摘要：

本文根据现有的临床研究及不同国家和地区高血压指南,针对血压测量的环境、方法、流程及血压计袖带等不同方面对血压值产生的影响进行了整理归纳。结果发现导致测量值偏高的因素有医务人员在场、使用水银血压计、流程不规范和使用较窄袖带,但是电子血压计袖带气囊的位置以及其与手臂间隔着4 mm以内的衣服对测量值没有影响。因此,应依据不同“血压”值分别制定合理的降压目标。对于不需紧急降压者,降压达标时间最好控制在4周左右,推荐钙离子通道阻断剂、血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂及利尿剂作为降压治疗的首选药物,当患者符合联合用药标准时,可以先使用一种降压药物观察血压下降情况后再按需增加药物种类启用联合治疗方案。

关键词: 高血压, 白大衣高血压, 抗高血压药, 血压测定

中图分类号:

R544.1

刘阔, 崔炜. 高血压诊疗基础问题再探讨:血压测量、降压目标、降压策略[J]. 临床荟萃, 2021, 36(8): 744-748.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.08.014

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I8/744

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参考文献 23

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血压测量方法		诊断标准(mmHg)
OBP		≥140和(或)≥90
ABPM	24小时平均值白天(或清醒状态)平均值夜晚(或睡眠状态)平均值	≥130和(或)≥80 ≥135和(或)≥85 ≥120和(或)≥70
HBPM		≥135和(或)≥85

血压测量方法		诊断标准(mmHg)
OBP		≥140和(或)≥90
ABPM	24小时平均值白天(或清醒状态)平均值夜晚(或睡眠状态)平均值	≥130和(或)≥80 ≥135和(或)≥85 ≥120和(或)≥70
HBPM		≥135和(或)≥85

高血压诊疗基础问题再探讨:血压测量、降压目标、降压策略

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