"This guide changes the diagnostic criteria for hypertension to ≥130/80 mmHg, which not only has sufficient international and domestic evidence-based medical evidence, but also the population with blood pressure levels between 130~139 mmHg and/or 80~89 mmHg are mostly young and middle-aged people. The downgrading of diagnostic criteria reflects the concept of moving the defense line forward and strengthening initial prevention. Otherwise, we will miss the critical opportunity to reduce the harm of cardiovascular diseases and other diseases caused by hypertension ." On November 13, the "China Hypertension Clinical Practice Guidelines" was released. At the online press conference, Professor Zhao Dong of Beijing Anzhen Hospital introduced one of the most important clinical issues in the guideline - the diagnostic criteria and grading related contents of hypertension. In his speech, Academician Han Yaling pointed out that under the guidance of the National Health Commission, the "China Hypertension Clinical Practice Guidelines" jointly formulated by National Cardiovascular Disease Center, Chinese Medical Association , Chinese Medical Association Hypertension Professional Committee, Chinese Medical Association Cardiovascular Branch, and Cross-Strait Medical and Health Exchange Association Hypertension Professional Committee was released.
Hypertension is the chronic disease with the largest number of patients in my country. With the progress of aging, the prevention and standardized diagnosis and treatment of hypertension are becoming more and more important. Professor Zhao Dong introduced that lifestyle intervention for people with blood pressure of 130~139/80~89mmHg and initiating antihypertensive drug treatment when non-drug treatment is ineffective is an important window period to reduce the adverse consequences of hypertension, which is generally cost-effective.
"Guidelines recommend that most patients with hypertension should reduce blood pressure to
"New guidelines simplify the risk of cardiovascular disease to high-risk and non-high-risk. For front-line clinicians, the simplified stratification of the stratification standards, the more operational and popularizable it is, which is conducive to judging the timing of antihypertensive treatment for patients with hypertension as soon as possible. " Huashan Hospital Affiliated to Fudan University Professor Li Yong introduced the content related to simplifying cardiovascular risk stratification in patients with hypertension. According to reports, blood pressure is higher than 140/90mmHg and systolic blood pressure 130~139 mmHg and/or diastolic blood pressure 80~89 Those with clinical comorbidities, target organ damage or ≥3 risk factors are listed as high-risk cardiovascular disease risks and require active drug intervention. At the same time, the new guideline includes the important complications of hypertension - atrial expansion - inclusion in target organ damage for the first time.
guideline sponsor and chief expert National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences Professor Cai Jun introduced that the guideline is a new evidence-based guide in the field of hypertension in my country, and the entire process is formulated by Chinese Academy of Medical Sciences Evidence-based Evaluation and Guidelines Research Innovation Unit and Lanzhou University Health Data Science Professor Chen Yaolong’s team provided methodological support.
Professor Cai Jun also pointed out that because the concepts and clinical issues covered in the field of hypertension are very wide, this guide only forms recommendations for the most important, important impact on clinical decision-making and the most controversial issues.
Academician Han Yaling introduced that the formulation of this guide strictly follows the World Health Organization’s guidebook and high-quality guidelines, which is an important measure to implement the cardiovascular prevention and control actions in healthy China, and has made great breakthroughs and changes in prevention, drug treatment and non-drug intervention, as well as secondary hypertension screening. I believe that the release of the 2022 "China's Clinical Practice Guidelines for Hypertension" will surely promote the progress of my country's hypertension prevention and control industry and promote the early realization of the goal of a healthy China.
It is understood that the guide will be officially published in the 11th issue of " Chinese Journal of Cardiovascular Disease " on November 24 (pre-published link: http://rs.yiigle.com/yufabiao/1432110.html).
Reference:
① China's Clinical Practice Guidelines for Hypertension, China Journal of Cardiovascular Disease, 2022, 50
[Attached Interpretation]
downgrade "10" is more suitable for my country's national conditions. A large number of sub-healthy people will be diagnosed as hypertensive patients. From November 13, a large number of sub-healthy people who have been defined as "pre-hypertensive stages" will be diagnosed as hypertensive patients. On November 13, the first "China's Clinical Practice Guidelines" was released. This new "Guidelines" lowers the diagnostic threshold for adult hypertension in my country from 140/90mmHg to 130/80mmHg.Professor Cheng Xiang and Associate Professor Su Guanhua, Director of the Department of Cardiovascular Medicine of Union Hospital Affiliated to Huazhong University of Science and Technology, interpreted the changes.
130/80mmHg is more suitable for China's national conditions
It is understood that the new "Guidelines" were jointly formulated and published by the National Center for Cardiovascular Diseases, the Chinese Medical Association, the Chinese Medical Association's Hypertension Professional Committee, the Chinese Medical Association's Cardiovascular Branch, and the Cross-Strait Medical and Health Exchange Association's Hypertension Professional Committee, in order to achieve standardization of clinical diagnosis and treatment of hypertension, and has extremely high authority.
Why does the new "Guidelines" lower the diagnostic threshold of hypertension by 10mmHg, that is, change from 140/90mmHg to 130/80mmHg?
Experts introduced that the Chinese medical community has been studying how to form a diagnostic standard of hypertension suitable for China's national conditions based on the evidence accumulated by clinical research and health economics assessment. The diagnostic standards for hypertension in my country range from 160/95mmHg proposed in 1977 to 140/90mmHg proposed in 1997 to 130/80mmHg today.
The adjustment of this standard mainly comes from the epidemiological data of our Chinese. Experts said that people with blood pressure between "130/80mmHg and 140/90mmHg" were previously believed to be at a "normal high value" and were also called "pre-hypertensive" people. New research has found that most of these people who have not been diagnosed with hypertension have not received timely intervention, so there is a potential risk of cardiovascular and cerebrovascular diseases. The formulation of new standards is mainly to move the prevention and control ports forward, so that more people in the past "normal high value" will be diagnosed, so that they can track and monitor, drug treatment and long-term management, and the earlier treatment, the greater the benefit, which will greatly reduce the risk of cardiovascular and cerebrovascular diseases.
Hypertension classification is simplified to level 2
New "Guidelines" divide adult hypertensive patients in my country into level 1 and level 2 according to their blood pressure levels.
1: systolic pressure 130-139mmHg and/or diastolic pressure 80-89mmHg;
2: systolic pressure ≥140mmHg and/or diastolic pressure ≥90mmHg.
Doctors will combine physical indicators and other comprehensive factors for patients with grade 1 and 2 to carry out necessary non-pharmaceutical interventions and drug treatments.
cardiovascular risk stratification is simplified to "high-risk" and "non-high-risk"
The new "Guidelines" have adjusted the cardiovascular risk stratification of patients with hypertension. In the past, the cardiovascular risk stratification of hypertension was divided into four types: low-risk, medium-risk, high-risk and extremely high-risk, but now it is only divided into high-risk and non-high-risk.
high-risk patients:
① Systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg;
② Systolic blood pressure 130-139mmHg and/or diastolic blood pressure 80-89mmHg with clinical comorbidities, target organ damage or ≥3 cardiovascular risk factors (such as smoking, abnormal blood sugar, abnormal blood lipids, obesity, etc.).
non-high-risk patients:
systolic blood pressure of 130-139 mmHg and/or diastolic blood pressure of 80-89 mmHg and does not meet the above high-risk standards.
cardiovascular risk stratification is high-risk patients, and it is recommended to start antihypertensive medication immediately.
cardiovascular risk stratification is non-high-risk patients, and lifestyle intervention can be performed for 3-6 months. If the systolic blood pressure is still ≥130mmHg and/or diastolic blood pressure is ≥80mmHg, antihypertensive drug treatment can be considered.
New "Guide" teaches you to measure blood pressure at home
New "Guide" teaches you to measure blood pressure like this during your stay at home:
1. Measure blood pressure once every morning and evening;
2. Get at least 2 consecutive blood pressure readings each time each time, with each reading interval of 1-2 minutes, and take the average of the readings twice. If the difference between the readings of the first and second blood pressure is > 10mmHg, it is recommended to measure the third time and take the average of the readings after the second time;
3. Avoid strenuous exercise, drinking alcohol, drinking caffeine-containing beverages and smoking 30 minutes before measuring blood pressure; before each measurement, rest quietly for 3-5 minutes. Wear loose clothes and don't roll your sleeves up.
4. Measuring period:
Morning: Measure before taking medicine, before breakfast, and after urination.
Night: Before dinner, if you miss it, measure it within 1 hour before going to bed; if you take medicine at night, it is recommended to measure it before taking medicine.
5. Preliminary diagnosis or blood pressure is not controlled: Patients with initial diagnosis or blood pressure not controlled and stable, blood pressure will be measured for at least 3 consecutive days per week.
6. Those with good blood pressure control: blood pressure measurements are performed 1-2 days a week.
[Link] Four questions about blood pressure measurement
1. Use an electronic blood pressure meter or a mercury blood pressure meter?
electronic blood sphygmomanometer is safer and more reliable. Mercury blood sphygmomanometers are prone to errors and have hidden dangers of mercury leakage. At present, mercury blood sphygmomanometers have been completely discontinued. Electronic blood pressure meter has good accuracy and repeatability. It is recommended that adults choose upper-arm electronic blood pressure meter produced by regular manufacturers.
2. How to calculate the right cuff? The most common reason for the inaccurate blood pressure is that the cuff is not suitable, and it is not OK to be too big or too small. Most people can use standard-specific cuffs. For those with obese or large arm circumference, large-specific cuffs can be used, while for children, small-specific cuffs can be used.
3. Measure the left hand or the right hand?
The blood pressure is measured for the first time, both arms are measured, and the side with high blood pressure shall prevail. Those with long-term blood pressure can fix one side.
4.Sitting or lying down?
You should sit while measuring blood pressure. If the situation does not allow it, you can lie down and measure it. Take a supine position and cannot lie on your side. Remember to keep the cuff at the same height as the heart.
(People's Daily Health Client)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-