人们普遍认为,高血压是重要的心血管危险因素,治疗高血压(BP)可有效降低心血管风险。亚洲的一个重要问题不仅仅是高血压的高患病率,特别是在一些国家,但许多地区的知晓率和治疗率也很低。2017年美国心脏病学会/美国心脏协会高血压指南的更新提出了一个问题,即应该使用哪种BP阈值来诊断和治疗高血压。尽管考虑到该地区高血压的种族特征,在亚洲有更严格的BP标准的理论基础。大多数亚洲国家保留了≥140/90mmHg的诊断BP阈值.虽然降低门槛可能有理论意义,这将增加高血压的患病率,并显著降低血压控制率.此外,目前没有来自稳健的随机临床试验的数据,表明较低的目标在预防心血管疾病和降低心血管风险方面的益处,特别是高危患者,特别是亚洲人群。对于130/80mmHg的办公室BP治疗目标,也没有定义的家庭BP治疗目标水平。然而,在这方面,在此期间,改变生活方式,包括减少体重和盐的摄入量,应该成为亚洲高血压管理策略的重要组成部分,而在亚裔人群中以较低的BP阈值水平进行治疗并达到较低的BP目标的研究将有助于告知和优化该地区的高血压管理。
It is widely accepted that hypertension constitutes a significant cardiovascular risk factor and that treating high blood pressure (BP) effectively reduces cardiovascular risk. An important issue in Asia is not just the high prevalence of hypertension, particularly in some countries, but also the low level of awareness and treatment rates in many regions. The 2017 update of the American College of Cardiology/American Heart Association hypertension guidelines raised the question about which BP threshold should be used to diagnose and treat hypertension. Although there is a theoretical rationale for a stricter BP criterion in Asia given the ethnic-specific features of hypertension in the region, the majority of countries in Asia have retained a diagnostic BP threshold of ≥140/90 mm Hg. Although lowering thresholds might make theoretical sense, this would increase the prevalence of hypertension and also markedly reduce BP control rates. In addition, there are currently no data from robust randomized clinical trials of the benefits of the lower targets in preventing cardiovascular disease and reducing cardiovascular risk, particularly in high-risk patients and especially for Asian populations. There is also no defined home BP treatment target level for an office BP treatment target of 130/80 mm Hg. However, in this regard, in the interim, lifestyle modifications, including reducing body weight and salt intake, should form an important part of hypertension management strategies in Asia, while studies on treating at lower BP threshold level in Asians and getting to lower BP targets will be helpful to inform and optimize the management of hypertension in the region.