图片来源:123RF
图片来源:123RF
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超重和肥胖:超重和肥胖是高血压患病的重要危险因素。中国成年人超重和肥胖与高血压发病关系的随访研究结果发现,随着体质指数(BMI)的增加,超重组和肥胖组的高血压发病风险是体重正常组的1.16~1.28倍。
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其他危险因素:年龄、高血压家族史、缺乏体力活动,糖尿病、血脂异常等。
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血压正常:诊室和诊室外血压均不升高(最佳血压:收缩压<130mmHg,舒张压<85mmHg;);
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持续性高血压:诊室和诊室外血压均升高;
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白大衣高血压(WCH):诊室血压升高,但诊室外血压不高;
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隐蔽性高血压(MH):诊室外血压升高,但诊室血压不高(血压正常偏高时考虑隐蔽性高血压,即收缩压130~139mmHg,舒张压85~89mmHg,强烈推荐诊室外血压评估)。
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首诊发现收缩压≥140mmHg和/ 或舒张压≥90mmHg,建议在 4 周内复查两次,非同日 3 次测量均达到上述诊断界值,即可确诊。
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反复出现的诊室血压升高,而诊室外的动态血压监测或家庭自测血压正常,为白大 衣高血压;相反,诊室血压正常,诊室外血压升高,为隐蔽性高血压。(具体诊断标准见下图)
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单纯收缩期高血压:收缩压≥140 mmHg且舒张压<90 mmHg。
诊室及诊室外血压诊断标准。(截图来源:参考资料[5])
参考资料
[1] More than 700 million people with untreated hypertension. Retrieved from https://www.who.int/news/item/25-08-2021-more-than-700-million-people-with-untreated-hypertension
[2] NCD Risk Factor Collaboration. (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, DOI: https://doi.org/10.1016/S0140-6736(21)01330-1
[3] Grassi, G., Quarti-Trevano, F., Seravalle, G., Dell’Oro, R., Vanoli, J., Perseghin, G., & Mancia, G. (2021). Sympathetic Neural Mechanisms Underlying Attended and Unattended Blood Pressure Measurement. Hypertension, HYPERTENSIONAHA-121.
[4] George S. Stergioua, Paolo Palatinib, Gianfranco Paratic,d, et al. (2021).2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressuremeasurement. J Hypertens. doi: 10.1097/HJH.0000000000002843. Online ahead of print.
[5] 国家基本公共卫生服务项目.国家基层高血压防治管理指南(2020版).retrieved 2020 年 12 月, from https://www.nccd.org.cn/Sites/Uploaded/File/2021/3/国家基层高血压防治管理指南%20A4版%202021-02-22.pdf
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