《2014年成人高血压管理指南（JNC8）》简介：

（1）60岁以上人群的目标血压为150/90mmHg,60岁以下人群目标值为140/90mmHg,包括糖尿病和肾脏病患者。

（2）噻嗪类利尿剂、CCB、ACEI和ARB四大类药物作为初始治疗药物（一线治疗药物，黑人仅利尿剂与CCB），可单独或联合使用；β受体阻滞剂退出一线，降至四线，与螺内酯同等地位。

（3）新指南强调了达标和维持目标（长期达标）[The main objective of hypertension treatment is to attain and maintain goal BP].

（4）新指南不是那么强烈推荐起始联合了[Some committee members recommend],而是“起始单药再单药加量”、“起始单药再加第二种”、“起始两种联合”三种策略都可以。

（5）肾病患者首选RAS阻断剂；糖尿病患者没有优先推荐RAS阻断剂，而是四种都可以；CCB减少卒中优于ACEI（中国的主要问题是卒中）。

《2014年成人高血压管理指南（JNC8）》内容预览：

Hypertension is the most common condition seen in primary care and leads to myocardialinfarction, stroke, renal failure, and death if not detected early and treated appropriately.Patients want to be assured that blood pressure (BP) treatment will reduce their diseaseburden, while clinicians want guidance on hypertension management using the best scientificevidence. This report takes a rigorous, evidence-based approach to recommend treatmentthresholds, goals, and medications in the management of hypertension in **s. Evidencewas drawn from randomized controlled trials, which represent the gold standard fordetermining efficacy and effectiveness. Evidence quality and recommendations were gradedbased on their effect on important outcomes.


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