A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension

被引：664

作者：

Olsen, Michael H. ^{[1
,2
,3
]}

Angell, Sonia Y. ^{[4
]}

Asma, Samira ^{[5
]}

Boutouyrie, Pierre ^{[6
,7
]}

Burger, Dylan ^{[8
]}

Chirinos, Julio A. ^{[9
]}

Damasceno, Albertino ^{[10
]}

Delles, Christian ^{[11
]}

Gimenez-Roqueplo, Anne-Paule ^{[17
,18
,19
]}

Hering, Dagmara ^{[20
]}

Lopez-Jaramillo, Patricio ^{[21
,22
]}

Martinez, Fernando ^{[23
]}

Perkovic, Vlado ^{[24
]}

Rietzschel, Ernst R. ^{[25
,26
]}

Schillaci, Giuseppe ^{[27
]}

Schutte, Aletta E. ^{[12
]}

Scuteri, Angelo ^{[13
]}

Sharman, James E. ^{[14
]}

Wachtell, Kristian ^{[15
]}

Wang, Ji Guang ^{[16
]}

机构：

[1] Univ Southern Denmark, Holbaek Hosp, Dept Internal Med, Odense, Denmark

[2] Univ Southern Denmark, Odense Univ Hosp, Ctr Individualized Med Arterial Dis CIMA, Odense, Denmark

[3] North West Univ, Hypertens Africa Res Team HART, Potchefstroom, South Africa

[4] New York City Dept Hlth & Mental Hyg, Div Prevent & Primary Care, New York, NY USA

[5] Ctr Dis Control & Prevent, Global NCD Branch, Div Global Hlth Protect, Ctr Global Hlth, Atlanta, GA USA

[6] Paris Descartes Univ, Georges Pompidou Hosp, Dept Pharmacol, Paris, France

[7] Paris Descartes Univ, Georges Pompidou Hosp, INSERM U 970, Paris, France

[8] Univ Ottawa, Ottawa Hosp Res Inst, Kidney Res Ctr, Dept Cellular & Mol Med, Ottawa, ON K1N 6N5, Canada

[9] Hosp Univ Penn & Vet Adm, Dept Med, Pittsburgh, PA USA

[10] Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique

[11] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow G12 8QQ, Lanark, Scotland

[12] North West Univ, HART, Res Council Unit Hypertens & Cardiovasc Dis, Potchefstroom, South Africa

[13] Policlin Tor Vergata, Dept Med, Hypertens Ctr, Hypertens & Nephrol Unit, Rome, Italy

[14] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia

[15] Oslo Univ Hosp, Dept Cardiol, Div Cardiovasc & Pulm Dis, Oslo, Norway

[16] Shanghai Jiao Tong Univ, RuiJin Hosp, Sch Med, Shanghai Inst Hypertens, Shanghai, Peoples R China

[17] Paris Cardiovasc Res Ctr, INSERM, UMR970, F-75015 Paris, France

[18] Paris Descartes Univ, F-75006 Paris, France

[19] Hop Europeen Georges Pompidou, AP HP, Dept Genet, F-75015 Paris, France

[20] Univ Western Australia, Royal Perth Hosp, Perth, WA, Australia

[21] Univ Santander, FOSCAL, Direcc Invest, Bucaramanga, Colombia

[22] Univ Santander, Fac Med, Inst Invest MASIRA, Bucaramanga, Colombia

[23] Univ Valencia, Hops Clin, Internal Med, Hypertens Clin, Valencia, Spain

[24] Univ Sydney, George Inst Global Hlth, Sydney, NSW, Australia

[25] Univ Ghent, Dept Cardiol, Ghent, Belgium

[26] Ghent Univ Hosp, Biobanking & Cardiovasc Epidemiol, Ghent, Belgium

[27] Univ Perugia, Dept Internal Med, Terni Univ Hosp, Terni, Italy

来源：

LANCET | 2016年 / 388卷 / 10060期

关键词：

LEFT-VENTRICULAR HYPERTROPHY; PULSE-WAVE VELOCITY; CORONARY-HEART-DISEASE; END-POINT REDUCTION; CONVERTING-ENZYME-INHIBITORS; CARDIOVASCULAR RISK-FACTORS; POSITIVE AIRWAY PRESSURE; OBSTRUCTIVE SLEEP-APNEA; MIDDLE-INCOME COUNTRIES; LIFE-STYLE INTERVENTION;

D O I：

10.1016/S0140-6736(16)31134-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Elevated blood pressure is the strongest modifiable risk factor for cardiovascular disease worldwide. Despite extensive knowledge about ways to prevent as well as to treat hypertension, the global incidence and prevalence of hypertension and, more importantly, its cardiovascular complications are not reduced-partly because of inadequacies in prevention, diagnosis, and control of the disorder in an ageing world. The aim of the Lancet Commission on hypertension is to identify key actions to improve the management of blood pressure both at the population and the individual level, and to generate a campaign to adopt the suggested actions at national levels to reduce the impact of elevated blood pressure globally. The first task of the Commission is this report, which briefly reviews the available evidence for prevention, identification, and treatment of elevated blood pressure, hypertension, and its cardiovascular complications. The report focuses on how as-yet unsolved issues might be tackled using approaches with population-wide impact and new methods for patient evaluation and education in the broadest sense (some of which are not always strictly evidence based) to manage blood pressure worldwide. The report is built around the concept of lifetime risk applicable to the entire population from conception. Development of subclinical and sometimes clinical cardiovascular disease results from lifetime exposure to cardiovascular risk factors combined with the susceptibility of individuals to the harmful consequences of these risk factors. The Commission recognises the importance of other cardiovascular risk factors-eg, smoking, obesity, dyslipidaemia, and diabetes mellitus-on antihypertensive treatment. However, as a Commission on hypertension, this report focuses mainly on issues and actions related to elevated blood pressure. Previous action plans for improving management of elevated blood pressure and hypertension have not yet provided adequate results. Therefore, the Commission has identified ten essential and achievable goals and ten accompanying, mutually additive, and synergistic key actions that-if implemented effectively and broadly-will make substantial contributions to the management of blood pressure globally. The Commission deliberately has not listed these complementary key actions by priority because the balance between strength of evidence, feasibility, and potential benefit could differ by country.

引用

页码：2665 / 2712

页数：48