medicina54巻7号

2017年06月発行

特集 外来診療必読エビデンス—日米比較で考える内科Standards of Excellence 各論

米国編　高血圧症の薬物療法

著者： 宮田加菜¹

所属機関： ¹

ページ範囲：P.1020 - P.1024

Point
◎JNC8では60歳以上の高齢者の目標血圧は150/90mmHg未満と定められたが，賛否両論である．
◎SPRINT試験では，ハイリスク患者において積極的治療の有効性が示された．
◎収縮期血圧と心血管系リスクには明らかな相関があるものの，拡張期血圧は過度に下げるとリスクが上昇する“Jカーブ”現象がみられる．
◎高血圧治療の第一選択薬は，一般的にはサイアザイド系利尿薬，Ca拮抗薬，ACE阻害薬またはARBで，CKD患者にはACE阻害薬またはARBが推奨されている．

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