Neurological Surgery 脳神経外科47巻1号

2019年01月発行

総説

脳血管障害外来患者の診療に役立つ高血圧症の管理

著者： 吾郷哲朗¹

所属機関： ¹九州大学大学院医学研究院病態機能内科学（第二内科）

ページ範囲：P.49 - P.60

Ⅰ．はじめに
　脳血管障害は日本人の国民病であり，その最大の危険因子は高血圧症である．近年，多様な薬効の降圧薬が登場し，高血圧症の治療は比較的容易なものとなった．また，脳血管障害発症予防の観点から最も重要なのは血圧値そのものであり，J-curve現象も存在しないという大規模試験の成果を信じるならば，血圧管理はそう難しいものではないだろう．しかしながら，目の前の患者は血圧が高いのみならず，さまざまな合併症を有していることも少なくないため，目標血圧値を定め，適切な降圧薬を選択するのが難しいと感じることも多い．本総説では，脳血管障害発症予防の立場から高血圧症をどのように診療し，管理するのがよいかについて私見を含め概説してみたい．

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