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JAMA：JNC8委员会发布2014年成人高血压治疗新指南

2013-12-19 箫砚 DXY

2014JNC8成人高血压
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JAMA杂志于12月18号发布了2014年成人高血压治疗指南（2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults），新指南包含9条推荐和一种治疗流程图来帮助医生治疗高血压患者。高血压是一种常见疾病，如果不能早期发现和治疗，容易引发心血管事件、中风、肾衰甚至死亡。新指南中推荐的起始治疗血压

JAMA杂志于12月18号发布了2014年成人高血压治疗指南（2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults），新指南包含9条推荐和一种治疗流程图来帮助医生治疗高血压患者。高血压是一种常见疾病，如果不能早期发现和治疗，容易引发心血管事件、中风、肾衰甚至死亡。新指南中推荐的起始治疗血压水平、治疗目标、以及治疗用药均有严格的证据支持。该指南制定专家组成员来自于Eighth Joint National Committee协会。新指南回答了三个常见问题：何时开始降压治疗专家组对需要开始治疗的血压水平进行明确。指南推荐，60岁以上老年人，血压达到150/90即应开始降压治疗；治疗目标值如上述。但是，专家组强调，新指南规定的这一血压界值并不是重新定义高血压，此前由Joint National Committee 7定义的高血压水平（>=140/90 mm Hg ）仍然有效。血压处于这一范围的人群，均应通过生活方式进行干预。血压治疗目标值新指南对以上三个问题的回答总体概括如下：

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    2014-07-19 12498768m13(暂无昵称)

    #新指南#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1923315, encodeId=15361923315da, content=<a href='/topic/show?id=1408583e45d' target=_blank style='color:#2F92EE;'>#新指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58374, encryptionId=1408583e45d, topicName=新指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Sat Jul 19 12:39:00 CST 2014, time=2014-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8215, encodeId=860d8215ae, content=历时十年指南终于更新，期待中国高血压指南的修订, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cac692029, createdName=laobasong, createdTime=Sun Mar 09 09:06:00 CST 2014, time=2014-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972892, encodeId=029019e28923a, content=<a href='/topic/show?id=fec81032049' target=_blank style='color:#2F92EE;'>#JNC8#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10320, encryptionId=fec81032049, topicName=JNC8)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Tue Oct 14 13:39:00 CST 2014, time=2014-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6449, encodeId=41356449ff, content=不要盲目遵循，临床工作中要重视国人个体差异与西方人的种族差异！, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=gaotieshan, createdTime=Wed Dec 25 10:01:00 CST 2013, time=2013-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6445, encodeId=87236445e4, content=10年磨一剑，使指南更简洁更明确，B受体阻滞剂在高血压治疗中的地位终于下降。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=751564749, createdName=zhenggang, createdTime=Mon Dec 23 21:00:00 CST 2013, time=2013-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6430, encodeId=6d7c6430c9, content=asdfasdf, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.231.249.202, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6431, encodeId=bfdc643195, content=123412341234, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=1234, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464286, encodeId=ec76146428689, content=<a href='/topic/show?id=d26f5393ee4' target=_blank style='color:#2F92EE;'>#成人高血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53937, encryptionId=d26f5393ee4, topicName=成人高血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5516658580, createdName=xiangyuzhou973, createdTime=Sat Dec 21 04:39:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6418, encodeId=05b26418e0, content=指南不断修正，其实是观念的修正，循证的进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=he, createdTime=Fri Dec 20 00:43:00 CST 2013, time=2013-12-20, status=1, ipAttribution=)]
    2014-03-09 laobasong

    历时十年指南终于更新，期待中国高血压指南的修订

    0

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    2014-10-14 ms8435843352634314

    #JNC8#

    0

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    2013-12-25 gaotieshan

    不要盲目遵循，临床工作中要重视国人个体差异与西方人的种族差异！

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1923315, encodeId=15361923315da, content=<a href='/topic/show?id=1408583e45d' target=_blank style='color:#2F92EE;'>#新指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58374, encryptionId=1408583e45d, topicName=新指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Sat Jul 19 12:39:00 CST 2014, time=2014-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8215, encodeId=860d8215ae, content=历时十年指南终于更新，期待中国高血压指南的修订, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cac692029, createdName=laobasong, createdTime=Sun Mar 09 09:06:00 CST 2014, time=2014-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972892, encodeId=029019e28923a, content=<a href='/topic/show?id=fec81032049' target=_blank style='color:#2F92EE;'>#JNC8#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10320, encryptionId=fec81032049, topicName=JNC8)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Tue Oct 14 13:39:00 CST 2014, time=2014-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6449, encodeId=41356449ff, content=不要盲目遵循，临床工作中要重视国人个体差异与西方人的种族差异！, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=gaotieshan, createdTime=Wed Dec 25 10:01:00 CST 2013, time=2013-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6445, encodeId=87236445e4, content=10年磨一剑，使指南更简洁更明确，B受体阻滞剂在高血压治疗中的地位终于下降。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=751564749, createdName=zhenggang, createdTime=Mon Dec 23 21:00:00 CST 2013, time=2013-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6430, encodeId=6d7c6430c9, content=asdfasdf, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.231.249.202, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6431, encodeId=bfdc643195, content=123412341234, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=1234, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464286, encodeId=ec76146428689, content=<a href='/topic/show?id=d26f5393ee4' target=_blank style='color:#2F92EE;'>#成人高血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53937, encryptionId=d26f5393ee4, topicName=成人高血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5516658580, createdName=xiangyuzhou973, createdTime=Sat Dec 21 04:39:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6418, encodeId=05b26418e0, content=指南不断修正，其实是观念的修正，循证的进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=he, createdTime=Fri Dec 20 00:43:00 CST 2013, time=2013-12-20, status=1, ipAttribution=)]
    2013-12-23 zhenggang

    10年磨一剑，使指南更简洁更明确，B受体阻滞剂在高血压治疗中的地位终于下降。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1923315, encodeId=15361923315da, content=<a href='/topic/show?id=1408583e45d' target=_blank style='color:#2F92EE;'>#新指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58374, encryptionId=1408583e45d, topicName=新指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Sat Jul 19 12:39:00 CST 2014, time=2014-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8215, encodeId=860d8215ae, content=历时十年指南终于更新，期待中国高血压指南的修订, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cac692029, createdName=laobasong, createdTime=Sun Mar 09 09:06:00 CST 2014, time=2014-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972892, encodeId=029019e28923a, content=<a href='/topic/show?id=fec81032049' target=_blank style='color:#2F92EE;'>#JNC8#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10320, encryptionId=fec81032049, topicName=JNC8)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Tue Oct 14 13:39:00 CST 2014, time=2014-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6449, encodeId=41356449ff, content=不要盲目遵循，临床工作中要重视国人个体差异与西方人的种族差异！, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=gaotieshan, createdTime=Wed Dec 25 10:01:00 CST 2013, time=2013-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6445, encodeId=87236445e4, content=10年磨一剑，使指南更简洁更明确，B受体阻滞剂在高血压治疗中的地位终于下降。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=751564749, createdName=zhenggang, createdTime=Mon Dec 23 21:00:00 CST 2013, time=2013-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6430, encodeId=6d7c6430c9, content=asdfasdf, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.231.249.202, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6431, encodeId=bfdc643195, content=123412341234, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=1234, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464286, encodeId=ec76146428689, content=<a href='/topic/show?id=d26f5393ee4' target=_blank style='color:#2F92EE;'>#成人高血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53937, encryptionId=d26f5393ee4, topicName=成人高血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5516658580, createdName=xiangyuzhou973, createdTime=Sat Dec 21 04:39:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6418, encodeId=05b26418e0, content=指南不断修正，其实是观念的修正，循证的进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=he, createdTime=Fri Dec 20 00:43:00 CST 2013, time=2013-12-20, status=1, ipAttribution=)]
    2013-12-21 116.231.249.202

    asdfasdf

    0

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    2013-12-21 1234

    123412341234

    0

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    2013-12-21 xiangyuzhou973

    #成人高血压#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1923315, encodeId=15361923315da, content=<a href='/topic/show?id=1408583e45d' target=_blank style='color:#2F92EE;'>#新指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58374, encryptionId=1408583e45d, topicName=新指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Sat Jul 19 12:39:00 CST 2014, time=2014-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8215, encodeId=860d8215ae, content=历时十年指南终于更新，期待中国高血压指南的修订, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cac692029, createdName=laobasong, createdTime=Sun Mar 09 09:06:00 CST 2014, time=2014-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972892, encodeId=029019e28923a, content=<a href='/topic/show?id=fec81032049' target=_blank style='color:#2F92EE;'>#JNC8#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10320, encryptionId=fec81032049, topicName=JNC8)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Tue Oct 14 13:39:00 CST 2014, time=2014-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6449, encodeId=41356449ff, content=不要盲目遵循，临床工作中要重视国人个体差异与西方人的种族差异！, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=gaotieshan, createdTime=Wed Dec 25 10:01:00 CST 2013, time=2013-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6445, encodeId=87236445e4, content=10年磨一剑，使指南更简洁更明确，B受体阻滞剂在高血压治疗中的地位终于下降。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=751564749, createdName=zhenggang, createdTime=Mon Dec 23 21:00:00 CST 2013, time=2013-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6430, encodeId=6d7c6430c9, content=asdfasdf, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.231.249.202, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6431, encodeId=bfdc643195, content=123412341234, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=1234, createdTime=Sat Dec 21 13:47:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464286, encodeId=ec76146428689, content=<a href='/topic/show?id=d26f5393ee4' target=_blank style='color:#2F92EE;'>#成人高血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53937, encryptionId=d26f5393ee4, topicName=成人高血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5516658580, createdName=xiangyuzhou973, createdTime=Sat Dec 21 04:39:00 CST 2013, time=2013-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=6418, encodeId=05b26418e0, content=指南不断修正，其实是观念的修正，循证的进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=he, createdTime=Fri Dec 20 00:43:00 CST 2013, time=2013-12-20, status=1, ipAttribution=)]
    2013-12-20 he

    指南不断修正，其实是观念的修正，循证的进步

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