【摘要】 目的 探讨高血压危象评估和处理原则及对高血压危象急诊处理的指导意义。 方法 依据高血压危象评估和处理原则对2008年1月-2009年12月期间收治的160例高血压危象患者进行诊断和治疗。结果 160例高血压危象患者中,高血压急症134例,高血压亚急症26例。高血压急症中,以心脑血管病变为主,包括脑卒中、急性冠脉综合征和急性左侧心力衰竭。依据高血压危象评估和处理原则进行急诊处理,能够对高血压危象进行准确评估和有效处理,减少诊治失误,降低死亡率并改善预后。结论 有关高血压危象的评估和处理原则能够指导高血压危象的急诊处理,取得良好的预后。【Abstract】 Objective To investigate the principles of evaluation and management of hypertensive crises in order to guide emergency clinical practice for better managements and prognosis. Methods One hundred and sixty patients with hypertensive crises admitted to our department from January 2008 to December 2009 had been diagnosed and treated. Results There were 134 patients with hypertensive emergencies (HE) and 26 patients with hypertensive urgencies(HU)in accordance with those principle. Cardiocerebralvascular diseases were the main symptom of HE including stroke, acute coronary syndrome and acute left ventricular failure. According to those principles,the emergency management was carried out, accuracy evaluation and effective management of hypertensive crises could reduce wrong diagnosis and treatment,decrease mortality and improve prognosis. Conclusion The principle of evaluation and management of hypertensive crises could guide the emergency management of hypertensive crises and obtain better prognosis．
摘要:目的:研究高血压病患者脂蛋白脂肪酶(liportein lipase, LPL)S447X基因多态性与认知功能之间的关系。方法: 对2008年1月至2008年11月在四川大学华西医院医院门诊就诊的原发性高血压患者190例,收集一般资料,采用国际通用的简易智力状况量表测验认知功能,计算认知评分,用聚合酶链反应限制性片段长度多态性(PCRRFLP)技术测定LPL S447X基因多态性。同时测定胆固醇、甘油三酯、空腹血糖、空腹胰岛素及餐后2h血糖、餐后2h胰岛素水平。结果: 高血压病患者认知功能正常组和认知功能障碍组组间LPLS447X基因的基因型和基因频率差异均无统计学意义(Pgt;0.05), SS和SX频率分别为92.6%、7.4%,S和X等位基因频率分别为96.3%和3.7%。结论: LPLS447X 基因多态性可能与高血压认知功能障碍无明显相关性。Abstract: Objective:To study the relationship between liportein lipase(LPL) S447X polymorphism and cognitive function in patients with primary hypertension. Methods:One hundred and ninety hypertensive patients from January 2008 to November 2008 in West China Hospital of Si Chuan University. We collected the general data and applied the Mini Mental State Examination to test the cognitive function and computed score. PCRRELP method was used to analyze the LPL S447X gene polymorphism. Total cholesterol、triglyeride、fasting plasma glucose and postprandial blood sugar、fasting insulin and postprandial plasma insulin were collected. Results:In primary hypertensive patients, both of the genotype frequency and the allele frequency of the LPL S447X polymorphism were not different between the cognitive normal group and the cognitive impaired group (Pgt;0.05). SS genotype was present in 0926 of the population, SX genotype was present in 0.074 of the population. allele frequencies were 0.963 for S allele and 0.037 for X allele. Conclusion:This results suggest S447X polymorphism in LPL with primary hypertension may not be associated with cognitive impairment. And age and postprandial plasma insulin level are the risk factors of hypertensive cognitive impairment.
Chronic kidney disease (CKD) and hypertension are very common chronic diseases. Active and standardized treatment of hypertension in patients with CKD can not only delay the progress of renal disease, but also reduce the risk of cardiovascular events. In recent years, although the guidelines for hypertension have put forward detailed suggestions for the management of hypertension in CKD patients, there are differences in the recommendation of blood pressure target value for CKD patients. Combined with the latest guidelines, this review interprets the blood pressure measurement methods, diagnostic criteria, antihypertensive targets and drug therapy in patients with CKD.
Objective To evaluate and select essential antihypertensive medicine using evidence-based approaches based on the burden of disease for township health centers located in eastern, central and western regions of China. Methods By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence. Results (1) Five clinical guidelines on hypertension were included, two of which were evidence-based. (2) Totally there were nine classes and 70 antihypertensive medicines listed in the guidelines. (3) According to WHOEML (2011), NEML (2009), CNF (2010), other guidelines, and the quantity and quality of evidence, we offered a b recommendation for nifedipine, verapamil and enalapril and a weak recommendation for hydrochlorothiazide, indapamide, spironolactone, propranolol, metoprolol and amlodipine. We made a recommendation against furosemide and timolol due to the lack of evidence from guidelines. (4) Nine recommended medicines have been marketed with the dosage forms and specifications corresponding to guidelines in China. The prices of metoprolol, amlodipine and enalapril were higher than those of other six (daily cost: metoprolol 3.80 to 7.60 yuan, amlodipine 2.16 to 4.32 yuan, and enalapril 0.86 to 6.88 yuan). As a whole, the prices of recommended antihypertensive medicine were affordable. (5) Results of domestic studies indicated that three bly-recommended medicines (including nifedipine, verapamil and enalapril) were safe, effective, economical and applicable. Conclusion (1) We offer a b recommendation for nifedipine, verapamil and enalapril as antihypertensive medicine and a weak recommendation for hydrochlorothiazide, indapamide, spironolactone, propranolol, metoprolol and amlodipine. (2) There is lack of high-quality evidence from relevant domestic studies, especially on long-term safety and pharmacoeconomic evidence. (3) We propose that more studies should be carried out on the safety, efficacy and pharmacoeconomics of six medicines for which we make a weak recommendation to produce high-quality local evidence.
ObjectiveTo investigate the significance of using the term "high-normal blood pressure" and its intervention in the early stage. MethodsIn 1992 and 2007, we performed two similar investigations focusing on cardiovascular risk factors in 711 people in Chengdu city. Since 114 individuals were diagnosed with hypertension, 597 people without hypertension were eligible and divided into two groups:the normal-pressure[<120/80 mm Hg (1 mm Hg=0.133 kPa)] group and the high-normal blood pressure (systolic blood pressure 120-139 mm Hg and/or diastolic blood pressure 80-89 mm Hg) group. Data in the two investigations were compared to explore the relationship among high-normal blood pressure, cardiovascular disease (CVD) and hypertension. ResultsThe high-normal blood pressure group had a higher level of CVD risk factors both in 1992 and 2007, and the 15-year cumulative incidence of hypertension in the high-normal blood pressure group was higher than that of normal-pressure group (91.2% vs. 22.2%, P<0.001). After adjusting for serum lipid, body weight and other CVD risk factors, high-normal blood pressure could predict the progression into hypertension[HR=5.354, 95% CI (4.094, 7.002), P=0.001]. There was no statistics difference in CVD prevalence in the two groups in 1992, but in 2007 the prevalence of CVD tended to be higher in the high-normal blood pressure group (6.6% vs. 3.1%, P=0.052). ConclusionHigh-normal blood pressure is a special stage of blood pressure with high level of CVD risk factors and high potential to progress into hypertension. The term should be emphasized and intervention should be done in the early stage for high-normal blood pressure people to prevent from hypertension and CVD.
Objective To analyze the current state, evaluate the accuracy, and determine the influencing factors of hypertension-related subscriptions from official health WeChat accounts. Methods The 36 official health WeChat accounts on the WeChat official accounts monthly list │ September 2022 China WeChat Top 500·New Rank certification were searched using the term "hypertension". We identified diabetes-related subscriptions published from April 1, 2022 to September 30, 2022. The accuracy of subscriptions was analyzed according to the consistency with clinical practice guidelines and was independently assessed by two specialists. SPSS 22.0 software was used for data analysis. Results One hundred and one subscriptions from 36 official health WeChat accounts were included. Forty-seven (46.5%) subscriptions were evaluated as consistent, seven (6.9%) subscriptions were evaluated as inconsistent, and forty-seven (46.5%) subscriptions were evaluated as unconfirmed. The differences between the numbers of reads, "wow" and "like" per thousand reads, were statistically significant. Consistency rates were higher for tweets backed by evidence and experts, and for tweets posted by public figures with the accreditation type "government". Conclusion Hypertension tweets have a good audience base, some of the content is inconsistent with current clinical guideline recommendations, and readers have little ability to screen them. There is a need to develop and improve the review mechanism for writing and publishing hypertension tweets on WeChat.