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JAMA Intern Med：轻度高血压接受降压治疗无心血管获益

2018-11-03 xujing 中国循环杂志

轻度高血压降压心血管
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根据JAMA子刊上发表的一项研究，轻度高血压患者接受抗高血压治疗不降低死亡率或心血管病风险，反而增加不良事件如低血压、晕厥和急性肾损伤的风险。

根据JAMA子刊上发表的一项研究，轻度高血压患者接受抗高血压治疗不降低死亡率或心血管病风险，反而增加不良事件如低血压、晕厥和急性肾损伤的风险。

这项研究纳入38 286例18~74岁的轻度高血压（未治疗的血压为140/90-159/99 mmHg）患者，均为低危患者，无心血管病史，无左心室肥厚、无房颤，无糖尿病、慢性肾脏疾病或早发性HD。

研究人员将19143例接受抗高血压药物治疗的患者（平均年龄55岁，治疗组）与19143例未经治疗的患者（平均年龄55岁，对照组）进行了比较。

随访5.8年。在随访期间，总共有1641人死亡。对照组总死亡率为4.08%，治疗组总死亡率为4.49%。

研究人员发现，抗高血压治疗未降低死亡率及心血管病风险。

高血压治疗反而增加不良事件风险，包括低血压、晕厥、电解质异常和急性肾损伤。

研究者表示，医生为轻度高血压的低危患者处方抗高血压药物时应当谨慎，因为这可能影响数百万人。

原始出处：
James P. Sheppard, et al. Benefits and Harms of Antihypertensive Treatment in Low-Risk Patients With Mild Hypertension. JAMA Intern Med. Published online October 29,2018. 

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    2018-11-17 jyzxjiangqin

    轻度高血压降压治疗。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=352880, encodeId=0ee035288006, content=轻度高血压降压治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 17 18:19:01 CST 2018, time=2018-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292005, encodeId=e3e812920056a, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360880, encodeId=e7e7136088064, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609289, encodeId=ac771609289b4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351445, encodeId=ab52351445d5, content=这么可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/24/d9d14db78de202d73276f47d8d8e2596.jpg, createdBy=3b682249905, createdName=盖伦, createdTime=Sun Nov 04 06:06:06 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351413, encodeId=b21e351413d1, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Nov 03 20:44:34 CST 2018, time=2018-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351404, encodeId=d3df351404d0, content=积极改善生活方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 03 20:18:59 CST 2018, time=2018-11-03, status=1, ipAttribution=)]
    2018-11-05 经常头晕

    #降压#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=352880, encodeId=0ee035288006, content=轻度高血压降压治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 17 18:19:01 CST 2018, time=2018-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292005, encodeId=e3e812920056a, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360880, encodeId=e7e7136088064, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609289, encodeId=ac771609289b4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351445, encodeId=ab52351445d5, content=这么可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/24/d9d14db78de202d73276f47d8d8e2596.jpg, createdBy=3b682249905, createdName=盖伦, createdTime=Sun Nov 04 06:06:06 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351413, encodeId=b21e351413d1, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Nov 03 20:44:34 CST 2018, time=2018-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351404, encodeId=d3df351404d0, content=积极改善生活方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 03 20:18:59 CST 2018, time=2018-11-03, status=1, ipAttribution=)]
    2018-11-05 xugumin

    #降压治疗#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=352880, encodeId=0ee035288006, content=轻度高血压降压治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 17 18:19:01 CST 2018, time=2018-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292005, encodeId=e3e812920056a, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360880, encodeId=e7e7136088064, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609289, encodeId=ac771609289b4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351445, encodeId=ab52351445d5, content=这么可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/24/d9d14db78de202d73276f47d8d8e2596.jpg, createdBy=3b682249905, createdName=盖伦, createdTime=Sun Nov 04 06:06:06 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351413, encodeId=b21e351413d1, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Nov 03 20:44:34 CST 2018, time=2018-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351404, encodeId=d3df351404d0, content=积极改善生活方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 03 20:18:59 CST 2018, time=2018-11-03, status=1, ipAttribution=)]
    2018-11-05 ms3994565386320060

    #Med#

    0

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    2018-11-04 盖伦

    这么可以

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=352880, encodeId=0ee035288006, content=轻度高血压降压治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 17 18:19:01 CST 2018, time=2018-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292005, encodeId=e3e812920056a, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360880, encodeId=e7e7136088064, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609289, encodeId=ac771609289b4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351445, encodeId=ab52351445d5, content=这么可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/24/d9d14db78de202d73276f47d8d8e2596.jpg, createdBy=3b682249905, createdName=盖伦, createdTime=Sun Nov 04 06:06:06 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351413, encodeId=b21e351413d1, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Nov 03 20:44:34 CST 2018, time=2018-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351404, encodeId=d3df351404d0, content=积极改善生活方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 03 20:18:59 CST 2018, time=2018-11-03, status=1, ipAttribution=)]
    2018-11-03 天地飞扬

    了解一下，谢谢分享！

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=352880, encodeId=0ee035288006, content=轻度高血压降压治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 17 18:19:01 CST 2018, time=2018-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292005, encodeId=e3e812920056a, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360880, encodeId=e7e7136088064, content=<a href='/topic/show?id=87fe98146d7' target=_blank style='color:#2F92EE;'>#降压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98146, encryptionId=87fe98146d7, topicName=降压治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609289, encodeId=ac771609289b4, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Nov 05 06:30:00 CST 2018, time=2018-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351445, encodeId=ab52351445d5, content=这么可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/24/d9d14db78de202d73276f47d8d8e2596.jpg, createdBy=3b682249905, createdName=盖伦, createdTime=Sun Nov 04 06:06:06 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351413, encodeId=b21e351413d1, content=了解一下，谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Nov 03 20:44:34 CST 2018, time=2018-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351404, encodeId=d3df351404d0, content=积极改善生活方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 03 20:18:59 CST 2018, time=2018-11-03, status=1, ipAttribution=)]
    2018-11-03 医者仁心5538

    积极改善生活方式

    0

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