高血压的标准化治疗方案:全球可用性,特点和与高血压指南建议的一致性
Gautam Satheesh1, Rupasvi Dhurjati1, Mark D Huffman2,3
1The George Institute for Global Health, Sydney, New South Wales, Australia.
Journal of hypertension
|December 18, 2023
概括
全球高血压控制是不理想的. 标准化治疗方案 (STP) 显示出潜力,但需要改进. 这项研究批判性地评估了STP,发现大多数需要与当前基于证据的指导方针保持一致,以更好地管理高血压.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 基于证据的医学基于证据的医学.
背景情况:
- 全球高血压控制仍然不理想,需要改进治疗策略.
- 标准化治疗方案 (STP) 为高血压有效管理提供了一个有前途的方法.
- 这项研究批判性地评估了现有的STP,以确定需要改进的领域.
研究的目的:
- 确定和描述全球高血压标准化治疗方案 (STP).
- 批判性地评估确定STP的质量和与当前指导方针的调整.
- 评估STPs在改善高血压控制方面的潜力.
主要方法:
- 定义了用于初级高血压药理治疗的STP.
- 从卫生组织的网站,搜索引擎和专家咨询 (直到2023年7月) 确定了STP.
- 排除了二次性,妊娠期或恶性高血压的STP;评估包括使用HEARTS in the Americas检查清单并与2021年世卫组织指南相比较的STP.
主要成果:
- 确定了50个STP,所有这些STP都具有阶段性治疗和指南推的第一线药物.
- 大多数人建议单疗法 (54%与CCB),只有44%开始组合疗法和16%的单药组合.
- 在完整的剂量信息 (74%) 和目标血压控制时间表 (只有一个STP) 中发现了显著的差距. 平均 HEARTS 检查清单得分为 68%.
结论:
- 虽然全球存在众多的STP,但大多数都需要大幅改进.
- 改进的重点应该是使STP与最新的基于证据的指导方针保持一致.
- 多方利益相关者的参与对于优化STP和改善全球高血压控制至关重要.
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