CAJ | 학술논문

2013年被誉为“高血压指南年”，《2014年美国成人高血压管理指南》（JNC 8）于2013年发布，该指南明确了高血压领域三个核心问题：（1）何时启动降压治疗；（2）降压治疗的靶目标值是多少；（3）如何选择降压药物。糖尿病肾病患者中，80%伴有血压升高，合理地选择降压药物并有效地控制血压，对糖尿病肾病的防治及预后有重大意义。JNC 8推荐的一线降压药物，包括血管紧张素转换酶抑制剂（ACEI）、血管紧张素Ⅱ受体阻滞剂（ARB）、钙离子拮抗剂（CCB）和利尿剂。该指南提出：≥18岁且＜60岁的糖尿病肾病患者血压应控制在140/90 mmHg以下，继续强化降压获益很少，且造成的不良后果的发生率增加；糖尿病肾病患者降压方案，首选ACEI或ARB，因其降低血压的同时兼具肾脏保护作用。
2013년피예위“고혈압지남년”，《2014년미국성인고혈압관리지남》（JNC 8）우2013년발포，해지남명학료고혈압영역삼개핵심문제：（1）하시계동강압치료；（2）강압치료적파목표치시다소；（3）여하선택강압약물。당뇨병신병환자중，80%반유혈압승고，합리지선택강압약물병유효지공제혈압，대당뇨병신병적방치급예후유중대의의。JNC 8추천적일선강압약물，포괄혈관긴장소전환매억제제（ACEI）、혈관긴장소Ⅱ수체조체제（ARB）、개리자길항제（CCB）화이뇨제。해지남제출：≥18세차＜60세적당뇨병신병환자혈압응공제재140/90 mmHg이하，계속강화강압획익흔소，차조성적불량후과적발생솔증가；당뇨병신병환자강압방안，수선ACEI혹ARB，인기강저혈압적동시겸구신장보호작용。
2013 was known as the hypertension guide year, 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults (JNC 8) was published in this year, this guide identified 3 core questions on the field of hypertension: What’s the right time to initiate antihypertensive pharmacologic therapy? What’s the specified BP goal with antihypertensive pharmacologic therapy? How to choose antihypertensive drugs? There were 80%people associated with high blood pressure in diabetic nephropathy patients, so a reasonable choice of antihypertensive drugs and effectively control blood pressure had a great significance on the prevention and prognosis of diabetic nephropathy. JNC 8 recommended first-line antihypertensive drugs, including ACEI, ARB, CCB, and Diuretics. The guide presents:the goal BP of patients with diabetic nephropathy aged 18 years to 60 years should be setted at 140/90 mmHg, setting a lower goal BP in this age group provides no additional benefit, while increasing the incidence of the adverse consequences; we preferred ACEI or ARB in patients with diabetic nephropathy, because it can not only decrease blood pressure, but also effectively protect renal function.