在最近的临床试验和指导建议之前和之后,血压管理中的时间模式
Eric J Brandt1,2, Craig J Beavers3, Zhuxuan Fu4
1Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Journal of clinical hypertension (Greenwich, Conn.)
|March 18, 2025
概括
这项研究检查了血压 (BP) 目标的实现和在主要高血压指南更新后的抗高血压药物处方趋势. 虽然在统计学上显著,但在实现办公室内静脉压目标方面观察到的增加很小,并且与相关性最小.
科学领域:
- 心脏病学 心脏病学
- 临床实践指南 临床实践指南
- 公共卫生 公共卫生
背景情况:
- 高血压管理指南不断发展,影响临床实践.
- 评估指南变化对患者结果的现实影响至关重要.
- 之前的研究还没有完全评估临床医生的行为转变对JNC-8,SPRINT和2017年高血压指南的反应.
研究的目的:
- 分析老年人实现血压 (BP) 目标的趋势.
- 评估抗高血压药物处方模式的变化.
- 为了确定临床医生的行为是否与关键的高血压指南出版物暂时相关.
主要方法:
- 使用国家心血管数据注册表 (NCDR) 实践创新和临床卓越 (PINNACLE) 注册表.
- 包括65岁以上患有高血压的大量患者 (n=3,678,774).
- 分析了2013年至2018年的数据,重点关注与指南发布的时间关系.
主要成果:
- 从2013年到2018年,观察到在办公室实现系统性血压 (SBP) 的统计学上显著增加.
- 观察到的SBP目标实现的增加很小,被认为是临床相关性的最小值.
- 抗高血压药物处方的趋势和临床医生的整体行为转变需要进一步详细分析.
结论:
- 虽然指南旨在改善BP控制,但它们对实现BP目标的实际影响可能很小.
- 对临床实践模式和患者结果的持续监测至关重要.
- 需要进一步研究以了解影响指南转化为显著临床改善的因素.
相关概念视频
01:28Factors affecting Blood pressure
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
01:25Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
01:28Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
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Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...