Початковий підхід до лікування високого артеріального тиску
BP | ASCVD Risk < 10% | ASCVD Risk ≥ 10% | Clinical ASCVD* |
|---|---|---|---|
Elevated: 120–129/< 80 | Lifestyle changes, reassess in 3 to 6 months | Lifestyle changes, reassess in 3 to 6 months | Lifestyle changes, reassess in 3 to 6 months |
Stage 1 Hypertension: 130–139/80–89 | Lifestyle changes, reassess in 3 to 6 months | Monotherapy, reassess in 1 month† | Monotherapy, reassess in 1 month† |
Stage 2 hypertension‡: Systolic ≥ 140 OR Diastolic ≥ 90 | Combination therapy (2 antihypertensive medications), reassess in 1 month† | Combination therapy, reassess in 1 month† | Combination therapy, reassess in 1 month† |
* Coronary artery disease, heart failure, or stroke | |||
† Lifestyle changes also are recommended for all patients receiving pharmacologic therapy. | |||
‡ For BP 140–159/90–100, consider starting with 2 medications (of different classes). For BP ≥ 160/100, definitely use 2 medications and reassess frequently. | |||
Data from Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Hypertension 2018 Jun;71(6):e136-e139] [published correction appears in Hypertension 2018 Sep;72(3):e33]. Hypertension 71(6):1269-1324, 2018. doi:10.1161/HYP.0000000000000066 | |||
ASCVD = atherosclerotic cardiovascular disease; BP = blood pressure. | |||