中国高血压防治指南2010-北京市体检网.doc

中国高血压防治指南2010 中国高血压防治指南修订委员会 摘要：2010年中国高血压防治指南是在1999年和2005年版本基础上修订的，由高血压联盟（中国）和国家心血管病中心组织近百位专家，包括心内科、肾脏科、神经科、老年科和内分泌科等学科专家多次讨论编撰而成。过去几十年来，我国人群高血压患病率呈增长态势。2002年全国调查结果显示，我国成人高血压患病率为18.8%。与1991年比较，高血压知晓率、治疗率和控制率有所改善，但与发达国家比较仍然处于较低水平。有些社区高血压管理后的控制率超过60%。农村脑卒中死亡率呈增长态势；城市中老年人群高血压主要并发症—脑卒中死亡率呈逐渐下降趋势，但在年轻人群中却是增加的。高血压是一种“心血管综合征”防治策略应当基于心血管总体危险的评估（危险因素、靶器官损害、伴随临床疾患）。一般高血压患者的降压目标是140/90mmHg（1mmHg=0.133kPa），≥65岁的老年人降压目标是150/90mmHg,如果能耐受还可进一步降低至140/90mmHg；糖尿病、肾脏病和冠状动脉性心脏病的降压目标为130/80mmHg；对高危患者管理应个体化。生活方式的改善如限盐、戒烟、减重、限酒、增加钾摄入量及体力活动，对预防和控制高血压是有意义的。5大类降压药：钙拮抗剂、血管紧张素转换酶抑制剂、血管紧张素受体拮抗剂、利尿剂、β受体阻滞剂及固定复方制剂均可作为高血压初始或维持治疗的选择。特殊人群高血压需特别处理，如少儿、老年、妊娠、各种心血管并发症等。由于健康医疗政策和水平的差别，在指南实施过程中，建议采用两个不同级别的推荐（标准建议和基本建议），允许主管医师作出合适的选择。 关键词：高血压；药物治疗；疾病管理；指南 2010 Chinese guidelines for the management of hypertension Writing group of 2010 Chinese guidelines for the management of hypertension Abstract : The 2010 Chinese guidelines for the management of hypertension is an update of the previous versions in 2005 and 1999 A guldeline committee of nearly 100 members appointed by the Chinese Hypertension League（CHL）and the National Centre for Cardiovascular. Disease（NCCD）.in collaboration with the Chinese societies of cardiology. nephrology. neurology. gynecology and endocrinology . convened on several occasions and discussed the guidelines. drafted by a core writing group .ades . and reached 18.8% in the year 2002 .remain low compared to high income countries . in spite of substantial improvements since l991 . In some communities . the control rate of hypertension increased up to 60%. The mortality rate of stroke . which is the major compli cation of hypertension in the Chinese population ,gradually decreased during the period . more so in urban areas than in rural areas for the middle-aged and elderly populations : in the-younger age groups . however . it increased As hypertension is a cardiovas syndrome . the management strategy should be based on the overall risk of cardio vascular disease estimated wit