加拿大における大人の高血圧の診断と治療のための臨床実践ガイド
Rémi Goupil1, Ross T Tsuyuki2, Nancy Santesso3
1Service de néphrologie, Département de médecine, Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Montréal, Qc.
まとめ
この臨床実務ガイドラインは,成人における高血圧 (HTN) の管理を改善するために,初等医療提供者に対する実用的な,根拠に基づいた勧告を提供します. 診断と治療を標準化し 最終的には心臓血管疾患と死亡率を減らすことを目的としています
科学分野:
- 心臓病科
- 公衆衛生
- クリニカル・プラクティスのガイドライン
背景:
- カナダは高血圧 (HTN) 管理の元の世界的リーダーであり,治療と制御の割合が低下しています.
- この減少は,初等医療の更新された実用的な勧告を必要とします.
研究 の 目的:
- 成人の高血圧の管理を改善するために,初等ケアのための実証に基づいた,実用的な勧告を提供すること.
- 高血圧の診断と治療を 標準化する
主な方法:
- ガイドラインの作成にはGRADEアプローチとADAPTEプロセスを利用し,AGREE IIの基準を遵守しました.
- WHO HEARTS技術パッケージに基づく簡素化された,エビデンスに基づいたアルゴリズムに統合された勧告
- 利益の対立管理のためのガイドライン国際ネットワークの原則を遵守して,プライマリケア提供者,患者,方法論/HTNの専門家を含む多様な委員会を設立しました.
主要な成果:
- 成人の高血圧管理のための9つの主要な勧告を"診断"と"治療"に分類しました.
- 標準化された診断方法には,血圧測定と確認が含まれ,HTNをBP ≥130/80 mmHgとして定義します.
- 治療の推奨事項には,静脈動脈圧 (SBP) の目標値 < 130 mmHg,健康的なライフスタイル選択の強調,および薬剤療法への段階的なアプローチが含まれます.
結論:
- カナダの初等医療施設における高血圧治療の水準を高めることが主な目標です.
- 高血圧の正確な診断と最適な治療は,不良心血管疾患と死亡率を減らすために不可欠です.
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