研究估计新血压指南影响的成年人比例

Applying the updated 2014 blood pressure (BP) guideline to the U.S. population suggests that nearly 6 million adults are no longer classified as needing hypertension medication, and that an estimated 13.5 million adults would now be considered as having achieved goal blood pressure, primarily older adults, according to a贾马在线发布的研究与2014年美国心脏病学院科学会议一致。

Ann Marie Navar-Boggan, M.D., Ph.D., of Duke University Medical Center, Durham, N.C., and colleagues quantified the proportion of adults potentially affected by the updated 2014 recommendations, compared to the previous guideline, issued nearly 10 years ago (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [JNC 7]). The researchers used data from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010 (n = 16,372), and evaluated hypertension control and treatment recommendations for U.S. adults. The new guideline proposed less restrictive BP targets for adults 60 years of age or older and for those with diabetes and慢性肾病。

The authors estimate that the proportion of younger adults (18-59 years) in the U.S. considered to have treatment-eligible hypertension would be decreased from 20.3 percent under JNC 7 to 19.2 percent under the 2014 BP guideline and from 68.9 percent to 61.2 percent among older adults (≥ 60 years). Extrapolating these numbers to the population represented by this NHANES sample (U.S. adults in 2007) translates to a reduction in 5.8 million adults no longer classified as needing hypertension medication (70 million under JNC 7 to 64.2 million under the 2014 BP guideline).

符合BP目标的符合条件的高血压的成年人的比例也略微增加了年轻的成年人，从2014年BP指南下的JNC 7至47.5％以下的41.2％，更大老年人，从40.0％到65.8％。

作者估计，在新的准则下，目标BP将在GOB上估计1350万未被视为达到BP目标的成年人，其中大多数受到60岁及以上的大多数人，其中许多人有糖尿病，慢性肾病和心血管疾病。

总体而言，美国成年人的1.6％是18-59岁及27.6％的成年人60岁或以上的成年人接受了降低的药物药物，并满足了更严格的JNC 7目标。这些患者可能有资格获得2014年BP指南的不严格或没有BP疗法。

“公共卫生信息应该针对美国的大量成年人，根据新的指导方针改变建议，以确保新的建议不会导致意外后果成年人现在，“作者写道，”作者写道。“”需要进一步的研究以确定该新指南如何影响所获得的整体BP水平并确定对心血管疾病结果的相关影响。“

Harlan M.Krumholz，M.D.，S.M.，耶鲁大学医学院，康涅狄格州纽黑文，伴随着编辑，这些新的指导方针与他们的创新和争议建立了新的课程。

“导航可能是不舒服的，也许迫使临床医生用太长时间忽略的问题努力。虽然对医疗决策制定的医疗决策，倡导健康和促进健康环境和行为非常重要，但对于医学决策，它甚至是更重要的是为了确保将知情选择充分参与，该人员会充分参与该决定的风险和利益。当通过该镜头看时，关于指南的争议变得不那么有争议，重点转变为改善证据并产生更好的方式沟通以决策目的所知。通过指导对该信息的关注，已经将这些准则牢固地嵌入了这些指导方针，并对患者偏好进行了大胆的建议和尊重，他们可能已经完成了比他们所想象的更多。“

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