@ffiffiffimrE
mffiffiffimffim
H
l+l@i'
2003
4
s
-
6 E
Ifr
*WfrFd)ifliHfE Dffi J
*f
H!
HfrrE1r:F,ffi
H.
tEHI+FHH(-H|3EtA
.
ffi)Ftl
.
-#{f,fr)AHetrlEe@We*
eE
ffi
+)R+F
€
)
(
r)(
T
F-5#i
J N
C7
)
;
M
;:lfl
Ht
1='
He#i
H
zoos ffi
)rfl
(|afrE
/,1.ffi[+g)
HfrE+HH
(r)(TEqFi@)rft+FH')
o
m-{E }F
H
f;EE-
T
tE
"f
E
gil+t
E
Ht
EtrE
pi'
)6
T
(F
#
*tR.?
ffi.^,
€1g+Hfr.{HS
"
E
tEt
mEigrtr
x+n
Hong
Zhong
Li
THE REVELATION OF
NEW
DIRECTIONS
ONTHE
MANAGEMENT
OF
HYPERTENSION
IN
THE
WEST
The UK Framingham Heart Study
showed
high risks
of
hypertension
despite
normal blood
pressure
(BP)
at
age
of
55
-
earliest intervention
is
paramount.
The US 7th Report
ol
the
Joint
National Committee
on
the
Prevention, Detection,
Evaluation and
Treatment of High Blood Pressure (JNC
7)
ol2OO3 newly
defined "Pre-hyperten-
sion"
-
BP
120-139/80-89 to
empha-
size prompt lifestyle changes and early
intervention. Treatment goals arc
<1401
90
mm Hg (<130/80 mm Hg
for
diabetics). A combination of 2 medica-
tions
is
recommended
for BP
20110
mm
Hg above
the goal
BP initially.
For
patients complicated
by
coronaries, the
American Heart Association
(AHA)
stipulates extra care and Step
l-ll
diets.
European Guidelines emphasized more
on the
assessment
of
related
risk
factors.
ln
1999,
the World
Health
Organization (WHO) and the lnterna-
tional Society
of
Hypertension
(lSH)
first
stressed the relevance
of
gradation and
early
intervention of
these
risk factors.
Cunently,
great
details on related risk
factors
of
target organs at risk,
e.9.,
the
heart as well
as
related diseases, e.9.,
diabetes, are stipulated. Although treat-
ment
of
patients with
"high
risk" and
"extremely high risK'factors are similar,
the necessity of
more
active interven-
tions
is alerted.
The European
Guide-
lines also
has
drug contraindications,
e.9., thiazine diuretics should not
be
prescribed for patients with gout.
4€JNco4tJ.yx
c7,
M.W.ffi*
T6+" HF{,tre+gfHfirEF!
ad''ifr
&
i6 ffi ffi,A4X +.
T
ffi
TE
je
frtr
ffilU.
"
iE?EW
ryfr\ut
4
Effi
R
6Jf
nTw't*rR
"
JNC
7
U&*fi
frtJ
lE#
Wry6frnfu4# '
tHf^Ef
Fff
TF
";Ncz
f"",1j
,
*Ef0€'sooo
)F
+RWtr
tzffi
d
-'l't
fr\
ffiPl ffi
frfi.,
H
'
4€EEiE
(Framingham)
,L'ffH
6fr
n
fr\
F\#fr
H
#4
ffi
m
s s
ffi
E+
frr
E
EH#&u&A\+.ftffif.flfgo"t"
fiS4F4HXnE
",ffi.Ed
rso
-
r3s/
80
-
semmHs
-fi+fr[@tr{fift
t
soz
B0mmHg
A+EIV,
,ffiAry+Hfr"
Wfr\
fe,Fh
FleE
ffiffi
lE
" E+o
-
7
offi,^E++,
rft-r
t
5
/
7
54.185
/
I
I
5mmHg
HlH'fHfrrE#E
tr
^J
4t,.ffi
,E€
jHinzommHg
4€f 9FE€}B
l[
I
ommHg,,L'-ff[€Ffr
4E
+-h1J
tuFh.rfln-,f*
"
AffiRil,Fft+
'
+ri
E-
Ir
E i6'ffi
+
#J
E
UW
ltr
s
s
-
+o'/"
HtJ
flffi+F
-
zo
.-
zs
o/o
#J,bfllL
E
tEffi
5
o
%o
D)t,L.
i
E
i.6
H!
F
+."ffi(fr-dl
,dH?-faWtrHH!
ffiEK{fi
t
2mmHg,
EI&l
l@tl,H
E
4
&fit
IfuJTEE
"
tqffiratt-bYfrft
ffieffiafnffiR&trfl
H#*Jxcz
f€fi
T-'fEEm.EBtH
#JXfiM
A'
B|J,ffi.E**F"'120- 139/80-
B
gmmH
g "
Yttt
€t-t',H,
E tz"rRig
'(:
*.'rfi
)t
fi,H!
T
E
"
JNC 7flStr
E
Et+o
-
1
59/90.-ggmmHgEifu
I
*XHfrIE
'
>
t6o/toommHs#€
H
[frB.HfrE '
4TiH
T IRH#IIII
f;eEirEt'H4
"
+t
W47-E
ffi'{J.ts''
Xn
EzJt
*ft
t
zo
-
I
39/
80
-
89
rnrnHg#
D)
6.Z^-.fr.lFEhHmE
"
EtfL
,
HM.EETHWt-#"R*
,4ft7_-8.
HHtrnHAiE
'
€E-r,flhJNcz
fESH!
IHtrEEfiH] f!AffiEE€
4+)E-*ffifE
' ,fEH5.HftEE
Db'H!ffituEH#.frEkffi.
"
Ef,
#t'l
f""ffi
tfi
ffi
r
EmE,B,
#
ffi'b
ffi"E
fuFh;Y,ffi
"
ffifi.T
g.h
##mf+€
H!
+T,ffr
+FH
"
+tDtH
I993+
H +f
EffiDb?6HfrEfrIfiE
ffiE
frt€,t
ftl "
rggg4wHo-rsH
&
D'
Yf
H
m.E
+
Ff,
i6 tfi
ffi 9tfe,
FA
EqH
HO'}tr
"
BIJ4Y6trHJ[EHO
itEfg+,
wwtfft\,
€ffiffF.f&
fuW€l{tilftfi+F
"
tuWWR
'}tr$J#
.
+EHME
RE)TH
22
