2014成人高血壓治療指引JNC 8簡介

Introduction of 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults (JNC 8)

吳東昇(Tung-Sheng Wu) ； 陳永煌(Yeong-Hwang Chen) ； 林易申(I-Shen Lin) ； 王鍾慶(Chung-Ching Wang) ； 高東煒(Tung-Wei Kao) ； 張耀文(Yaw-Wen Chang)

《中華職業醫學雜誌》 21卷2期 (2014/04) Pp. 59-72

摘要

JNC 8於2013年12月公布，以實證醫學研究文獻為基礎，加上專家建議，相較JNC 7更加簡潔、實用。JNC 8共有以下建議：（1）在60歲以上的人，起始治療的時機為血壓高於150/90 mmHg，並以150/90 mmHg以下為目標。（2）在30至59歲的人，血壓控制目標為舒張壓低於90 mmHg。（3）小於60歲的成人，血壓控制目標建議低於140/90 mmHg。（4）成人高血壓合併糖尿病或非糖尿病引起的慢性腎臟疾病，其血壓控制目標建議低於140/90 mmHg。（5）在非黑人族群之中，包括患有糖尿病患者，建議應以血管張力素轉換酶抑制劑（ACEI）、血管張力素受體阻斷劑（ARB）、鈣離子通道阻斷劑（CCB）或thiazide類利尿劑為起始治療藥物。（6）在黑人高血壓族群，包括患有糖尿病的患者，建議以CCB或thiazide類利尿劑為起始治療藥物。（7）在慢性腎臟疾病患者，以ACEI、ARB為起始或增加的抗高血壓藥物，可以改善腎功能。

關鍵字

高血壓 ； 心血管疾病

並列摘要

JNC 8 was published in online December 18, 2013. It was evidence-based, and added the expert opinion. Comparing with JNC 7, it was simpler and more practical. The following recommendations the JNC 8 suggests:(1) In the general population older than 60 years, the timing of initiate pharmacologic treatment is systolic blood pressure (SBP)＞ 150 mmHg or diastolic blood pressure (DBP)＞90mm Hg and treat to a goal SBP ＜150 mm Hg and goal DBP ＜90 mm Hg.(2) In the general population age from 30 to 59 years, the goal DBP is lower than 90 mm Hg.(3) In the general population younger than 60 years, based on expert opinion, the goal blood pressure is lower than 140/90 mm Hg.(4) The goal blood pressure for hypertensive adults with diabetes or nondiabetic chronic kidney disease is lower than 140/90 mm Hg.(5) In the nonblack hypertensive population, including those with diabetes, initiating drug treatment should be one of angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic(6) In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy.(7) In persons with CKD , angiotensin-converting enzyme inhibitor or angiotensin receptor blocker should be initial or add-on antihypertensive drug, because they can improve kidney outcomes.

並列關鍵字

hypertension ； JNC 8 ； cardiovascular disease