Abstract:
Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains suboptimal, even to a conservative BP target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP, better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of health care services. Hopefully, the 2023 ESH will help enable this.
摘要:
临床实践指南非常适合提供有关预防的建议,诊断,评估,和高血压(BP)的管理。最近发布的欧洲高血压学会(ESH)2023ESH动脉高血压管理指南是一系列高BP临床实践指南中的最新指南。它非常类似于2018年欧洲心脏病学会/ESH指南,有增量而不是重大的变化。尽管ESH指南主要是为欧洲临床医生和公共卫生工作者编写的,其建议与其他主要BP指南中的建议高度一致.尽管世界各地有大量的国家和国际BP准则,一般人口调查表明,BP指南在世界任何地区都没有得到很好的实施。血压水平,这是诊断和管理的基础,在常规临床实践中测量仍然不佳,高血压的控制仍然欠佳,甚至达到保守的BP目标,如收缩压/舒张压<140/90mmHg。BP指南需要更多地关注实施准确诊断的建议和改善高血压患者控制的策略。不断发展的实施科学体系可以帮助实现这一目标。鉴于巨大的健康,社会,和高BP的财政负担,更好的诊断和管理应该是临床医生的当务之急,政府,和其他负责提供卫生保健服务的人。希望,2023年的ESH将有助于实现这一目标。