Nice new hypertension guidelines

• 作者: Bernard Man Yung Cheung Tommy Tsang Cheung
• 来源期刊: 世界高血压杂志
• 学科: 医学
• 关键词: Hypertension Guidelines Angiotensin-converting ENZYME inhibitor The National Institute for Clinical Excellence
• 年，卷（期）: 2012,（5）
• 页码范围: 45-49
• 页数: 5页
• 分类号: R

摘要

The National Institute for Clinical Excellence in the United Kingdom published a new set of guidelines on the management of primary hypertension in August 2011,reflecting some important changes in the diagnosis and treatment of hypertension.Ambulatory blood pressure measurement is now the new gold standard for diagnosis.Home blood pressure monitoring is a useful alternative for the diagnosis and monitoring of hypertension.Calcium channel blockers(CCB)and blockers of the renin-angiotensin system have surpassed diuretics andβ-blockers as first line options.Patients younger than 55 should receive an angiotensin-converting enzyme inhibitor,or an angiotensin receptor blocker if the former is not tolerated.Older patients should be started on a CCB.A thiazide diuretic can be added to these two groups for better blood pressure control,but.chorthalidone and indapamide are the preferred diuretics as they showed favorable outcomes in large clinical trials.Treatment with these three drug classes should be sufficient in the majority of patients,but if triple therapy is still insufficient,referral to a hypertension specialist is recommended.Additional diuretic therapy,spironolactone,or anαorβblocker can be used as the fourth line treatment.