The complete?The final text of the second edition of the guidelines for the rational use of high blood pressure has beenpublic.Directly available!

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Source 丨Chinese Journal of Medical Frontiers (E edition) 2017,9 (7): 28-126

“”Guidelines for the rational use of high blood pressure (2. Edition)

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Professor Sun Ningling



Preface


Hypertension is a chronic non-communicable disease.It is also the chronic disease with the h?next testvalence rate, the H?next disability?tsrate and the h?next burden of disease in China.


According to the National Commission for Health and Family Planning from 2016, the pr?valence of high blood pressure in adults aged 18 and over in China at 25.2%.Although the awareness, Treatment and Control Rates for Hypertension in the Chinese Bev?have improved in recent years,But still at a low level.


The global burden of disease research shows that the disabled-friendly years of life (DALY) of the Chinese Bev?Correction due to high blood pressure 37,94 million years.12 of the entire DALY are omitted.0%,63% of the total DALY of cardiovascular diseases.5%; Under them re?gt the year of death from disability (YLD) 35,57 million,Years of life lost in premature death (YLL) are 236 years.50.000 people per year,It makes up 50 of YLD and YLL in cardiovascular disease.1% and 64.5%,It is the first risk factor for exposure to cardiovascular disease.


The number of premature deathsll through receivedwould concern blood pressure in the country?gt j?more than 2 million per year.The j?Annual direct medical expenses are 36,6 billion.The results of a cohort study, which are published in the Chinese JAMA magazine?has been published showed this in 2016The blood pressure compliance rate of hypertensive patients after treatment in China is?gt 29.6%.


Is Hypertension the Most Important Risk Factor for Cardiovascular?re and cerebrovascular?re diseases.The epidemic situation is seriousThe main complications such as stroke, Myocardial infarction, Heart failure and chronic kidney disease have high disability and death rates.Seriously consume medical and social resources,Weigh heavily on family and society,It has become a major problem of?become public health in our country.


Although the diagnosis and treatment of high blood pressure has been great in recent yearse has made progress,High blood pressure drugs are also popping up endlessly.However, there are many irrationalities?th in the treatment of high blood pressure.This also affects compliance, Persistence and blood pressure control rate of patients.


In recent years, the National Commission on Health and Family Planning has implemented a tiered diagnosis and treatment strategy for high blood pressure.public.Suggested that the treatment of high blood pressure should be standardized,And do you sink to the prim?ren medical service center,This will be the rational use of drugs in a h?higher position f?turn,It is hoped that drugs used to treat high blood pressure are not only available in first-class hospitals?can be used sensibly.It can also be in prim?rkrankenh?can be standardized and used sensibly.


Based on,Two years after the first edition of the “Guidelines for the rational use of high blood pressure”,Pay attention to the ?changes in the treatment of high blood pressure,The Expert Committee of the National Commission on Health and Family Planning on the Rational Use of Medicines and the Expert Committee on Hypertension of the Chinese?medical association organized the updating and new edition of the guidelines.


In the second edition of the guidelines, the content of pharmacogenomics, Added new drugs in research and evidence-based recommendations for drugs.At the same time, add chapters on domestically manufactured innovative antihypertensive drugs with intellectual property rights.Enriched the content of the drug?sen treatment.


We hope, that this edition of the “Guidelines for the rational use of high blood pressure”?can help doctors Understand the importance of standardizing the use of antihypertensive drugs.Do you assign them?doctors To use antihypertensive drugs appropriately and appropriately under various blood pressure levels and various complications of hypertension.Improve your own level of treatment,Improving adherence and sustainability of patients with high blood pressure,Improving blood pressure control rate,Are you reducing cardiovascular?re and cerebrovascular?re events.

Sun Ningling

Director of the Hypertension Research Office of the University People’s Hospital?t Beijing

Expert?Committee of the National Health and Family Planning Commission for the rational use of medicines

Deputy head of the specialist group for cardiovascular?re medicinal products

Honorary Chairman of the Hypertension Professional Committee of the Chinese Medical Doctor Association


Evidence-based medical method description


13th October 2016 The joint committee for the revision of the guidelines consists of the expert committee of the National Commission for Health and Family Planning for the rational use of medicines and the Hypertension Expert Committee of the Chinese?medical association together.After 4 joint meetings after the discussion we closedlich the general reason?set out the revised guidelines and key questions, to be answered by the new guidelines.The Guidelines Working Group has formulated specific literature retrieval and evaluation strategies for these core issues.Comprehensive evaluation and review of relevant documents.The revision process mainly includes?the following functions:

(1) This guideline is based on the comprehensive search and review of clinically evidence-based research as far as m?resembled.It is made up of relevant experts and teams from the guidelines working group (experts in the fields of evidence-based medicine, Epidemiology, Cardiovascular diseases, High blood pressure, endocrine metabolism, Nephrology, Neurology and pharmacology).After the design is completed,After many revisions and verified by several parties.

(2) The working group of this guideline consists of experts from different disciplines.In particular, it is composed of experts which in hypertension research t?were good as well as experts in epidemiology and pharmacology.You are: Zeng Zhechun, Professor Zhan Siyan (experts in evidence-based medicine),Professor Wang Limin, Wang Zengwu, Sun Ningling (Chapter 1: The Pr?valence of high blood pressure and the current treatment status),Cai Jun, Chen Luyuan, Professor Liu Wei (Chapter 2: Classification of High Blood Pressure Drugs),Sun Ningling, Guo Yifang, Chen Yuanyuan, Lin Jinxiu, Chen Xiaoping, Feng Yingqing, Wang Hao, Chu Shaoli, Zhang Yuqing, Professor Lu Xinzheng (Chapter 3: Reason?rates and regulations for medication),Fan Li, Zhang Xinjun, Wu Haiying, Yuan Hong, Jing Xian, Li Jianping, Chen Yuanyuan, Professor Chen Luyuan (Chapter 4: Inl?Indian innovative drugs),Professor Lin Jinxiu, Sun gang, Tao Jun, Li Yuming, Xie Liangdi, Wang Hongyi, Li Yong, Sun Yuemin (Chapter 5: Principles of Drug?treatment of special hypertension complications),Zhu Zhiming, Jiang Yinong, Li Yuming, Mou Jianjun, Gao Pingjin, Li Nanfang, Song Lei and Yin Xinhua (Chapter 6: Treatment Principles and Drug Selection g?some special types of high blood pressure),Professor Sun Yingxian (Chapter 7: Principles of National Application of Essential Medicine for Patients with Prim?rer hypertension),Professor Zhao Zhigang (Appendix: List of h?most common antihypertensive drugs).After completion of the manuscript, the editors of the “Chinese Journal of Medical Frontiers (Electronic Edition)” are responsible for the preparation of the manuscript.CloseLich the editor-in-chief Professor Sun Ningling organized the revision and completion.

(3) The writing team deals with each core problem.Determine the literature search strategy,The databases searched contain relevant literature on the treatment of high blood pressure drugs, the 2006-2017 in databases such as PUBMED, EMBASE, CBMDISC, CNKI, Wanfang and Weipu CMCC ver?was published.And preliminary?frequent screening of the literature.

(4) Inclusion criteria for the literature screening: ① RCT: ≥ 50 pairs of well-designed randomized controlled clinical trials.Pay attention to the robustness of the results,It is best, a sensitivity?perform t analysis.② Observational studies: well represented?ecological studies, well represented cross-sectional studies, Cohort studies, Case-control studies and registration studies based on natural populations,The sample size should be> 1000 people.③Systematic review: The number of studies included in the review should be at least ≥3.Should include a meta-analysis.The same subjectW?select a systematic review, which contains more research?lt, is relatively new and a h?here quality?t of analytical research.

(5) For the selected?Did the writing team assess the quality?t the evidence based on the full?comprehensive text of the document.ThenFinally, the clinical experts of the working group made various recommendations for the core topic.The recommendation level is based on a systematic review of the quality of evidence?t and clinical practice.Formed by repeated discussions of multidisciplinary?ren experts,If the opinions of the experts differ,Do you fully accept the consensus of most experts on the basis of?taking into account different opinions.And form the final referral level.

(6) W?During the writing process, the results of the quality of evidence?evaluation and recommendation level of several recent editions of the most influential Chinese and international guidelines for testingvention and treatment of high blood pressure used or cited.

(7) The quality of evidence used in this guide?The evaluation and recommendation level relate to the standards of the Europ?ical Society for Cardiology.Do you take appropriate?changes before (Table 1,Table 2).

(8) The guideline development process relates to the standard overseas clinical guideline development process and the Chinese Medical Association.

Index to the contents of the magazine guide

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