血脂治疗与临床指南.ppt

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1、JNC7:ClassificationandManagementofBloodPressureforAdults**TreatmentdeterminedbyhighestBPcategory†TreatpatientswithchronickidneydiseaseordiabetestoBPgoalof<130/80mmHg‡InitialcombinedtherapyshouldbeusedcautiouslyinthoseatriskfororthostatichypotensionSBP=systolicbloodpressure;DBP=diastolicbloodpr

2、essure;ACEI=angiotensin-convertingenzymeinhibitor;ARB=angiotensinreceptorblocker;BB=b-blocker;CCB=calciumchannelblockerJNC7.May2003.NIHpublication03-5233.InitialDrugTherapyBPClassificationSBP*(mmHg)DBP*(mmHg)LifestyleModificationWithoutCompellingIndicationsWithCompellingIndicationsNorma

3、l<120and<80EncourageNoantihypertensivedrugindicated.Drug(s)forcompellingindications.†Prehypertension120–139or80–89YesStage1hypertension140–159or90–99YesThiazide-typediureticformost.MayconsiderACEI,ARB,BB,CCB,orcombination.Drug(s)forcompellingindications.†Otherantihypertensivedrugs(diuretic,

4、ACEI,ARB,BB,CCB)asneeded.Stage2hypertension³160or³100YesTwo-drugcombinationformost‡(usuallythiazide-typediureticandACEIorARBorBBorCCB).JNC7:TreatmentAlgorithmforHypertensionSBP=systolicbloodpressure;DBP=diastolicbloodpressure;ACEI=angiotensin-convertingenzymeinhibitor;ARB=angiotensinrecep

5、torblocker;BB=b-blocker;CCB=calciumchannelblockerJNC7.May2003.NIHpublication03-5233.Optimizedosagesoraddadditionaldrugsuntilgoalbloodpressureisachieved.Considerconsultationwithhypertensionspecialist.NotatgoalbloodpressureWithoutcompellingindicationsStage1hypertension(SBP140–159orDBP90–99mmHg)

6、Thiazide-typediureticformost.MayconsiderACEI,ARB,BB,CCB,orcombination.Stage2hypertension(SBP³160orDBP³100mmHg)Two-drugcombinationformost(usuallythiazide-typediureticandACEIorARBorBBorCCB).LifestylemodificationsNotatgoalbloodpressure(<140/90mmHg)(<130/80mmHgforthosewithdiabetesorchronickidn

7、eydisease)InitialdrugchoicesWithcompellingindicationsDrugsforcompellingindicationsOtherantihypertensivedrugs(diuretic,ACEI,ARB,BB,CCB)asneeded.ATPIII:NewFeaturesofGuidelines—FocusonMultipleRiskFactorsPersonswithdiabeteswithoutCHDraise