Νέες Αμερικανικές οδηγίες υπέρτασης

[paracelsus]

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 "This guideline now categorizes BP as normal (systolic BP [SBP] <120 mm Hg AND diastolic BP [DBP] <80 mm Hg); elevated (SBP 120-129 mm Hg AND DBP <80 mm Hg); stage 1 hypertension (SBP 130-139 mm Hg OR DBP 80-89 mm Hg); and stage 2 hypertension (SBP ≥140 mm Hg OR DBP ≥90 mm Hg)...From a clinical perspective, lowering the diagnostic thresholds for “hypertension” beyond previous guidelines will significantly increase the number of individuals with this diagnosis....Treatment recommendations are now based on an individual’s underlying cardiovascular disease (CVD) risk. For those with known CVD or diabetes, the guideline recommends intervention (both lifestyle and pharmacological treatment) for stage 1 hypertension (SBP ≥130 mm Hg or DBP ≥80 mm Hg). For all others, the guideline proposes use of BP-lowering medications in stage 1 hypertension only if a patient’s estimated 10-year atherosclerotic CVD (ASCVD) risk is 10% or higher. For those with lower ASCVD risk, lifestyle modification is recommended until the individual reaches stage 2 hypertension (140/90 mm Hg), above which drug therapy is recommended."

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“Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure.” This is the type of headline that raises my blood pressure to dangerously high levels.
A blood pressure of 130 in the Sprint study may be equivalent to a blood pressure of 140, even 150, in a busy clinic. A national goal of 130 as measured in actual practice may lead many to be overmedicated — making their blood pressures too low.
Serious falls are common among older adults. In the real world, will a nationwide target of 130, and the side effects of medication lowering blood pressure, lead to more hip fractures?
I suspect many primary-care practitioners will want to ignore this new target. They understand the downsides of the relentless expansion of medical care into the lives of more people. At the same time, I fear many will be coerced into compliance as the health care industry’s middle management translates the 130 target into a measure of physician performance. That will push doctors to meet the target using whatever means necessary — and that usually means more medications."