2017年ACC/AHA高血圧ガイドラインの米国の人口への潜在的な影響
Paul Muntner1, Robert M Carey2, Samuel Gidding3
1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama (P.W.) pmuntner@uab.edu.
Circulation
|November 15, 2017
まとめ
2017年のACC/AHA高血圧ガイドラインは,JNC7と比較して,米国成人における診断された高血圧の有意な増加を示しています. また,多くの患者に対して,より多くの薬剤と集中的な血圧管理を推奨しています.
科学分野:
- 心臓病科
- 公衆衛生
- エピデミオロジー
背景:
- 2017年のアメリカ心臓学会/アメリカ心臓協会 (ACC/AHA) のガイドラインは,高血圧管理のための最新の勧告を提供します.
- これらのガイドラインは高血圧を定義し,薬剤の開始のための血圧 (BP) 値を確立し,目標BPを設定します.
研究 の 目的:
- 2017年ACC/AHAガイドラインとJNC7ガイドラインの間の高血圧の流行と治療の推奨を比較する.
- ガイドラインの2つの基準に基づいて,米国の成人の間で制御されていないBPの流行を評価する.
主な方法:
- 2011~2014年の全国保健栄養調査 (N=9,623) のデータ分析
- 標準化された3回分の血圧測定は,アメリカの人口の推定値の平均と重み付けを行いました.
主要な成果:
- 2017年のACC/AHAガイドラインでは,JNC7 (31. 9%) に比べて高血圧の罹患率が高かったことが確認された.
- 抗高血圧薬は,ACC/ AHAでは36. 2%,JNCでは34. 3%が推奨されました.
- 薬剤を服用している米国の成人の半数以上 (53. 4%) は,ACC/AHAごとに目標値を超える高血圧であったが,JNC7では39. 0%であった.
結論:
- 2017年のACC/AHAガイドラインは,診断された高血圧の有意な増加につながります.
- 薬の推奨値のわずかな上昇と 治療対象者の高血圧管理の目標値の強化に繋がります
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