延緩老年高血壓進(jìn)展的護(hù)理干預(yù)演講人2025-12-25

老年高血壓的病理生理特點(diǎn)與風(fēng)險(xiǎn)評(píng)估壹延緩老年高血壓進(jìn)展的綜合護(hù)理干預(yù)措施貳護(hù)理干預(yù)的效果評(píng)價(jià)與持續(xù)改進(jìn)叁結(jié)語(yǔ)肆參考文獻(xiàn)伍參考文獻(xiàn)陸目錄參考文獻(xiàn)柒

延緩老年高血壓進(jìn)展的護(hù)理干預(yù)摘要本文系統(tǒng)探討了延緩老年高血壓進(jìn)展的護(hù)理干預(yù)策略。通過(guò)科學(xué)理論支撐與臨床實(shí)踐相結(jié)合，詳細(xì)闡述了老年高血壓的病理生理特點(diǎn)、風(fēng)險(xiǎn)評(píng)估方法、綜合護(hù)理干預(yù)措施以及效果評(píng)價(jià)體系。研究表明，系統(tǒng)化的護(hù)理干預(yù)能夠顯著改善老年高血壓患者的血壓控制水平，延緩心血管并發(fā)癥的發(fā)生，提高患者生活質(zhì)量。本文旨在為臨床護(hù)理人員提供科學(xué)、實(shí)用的護(hù)理干預(yù)方案，推動(dòng)老年高血壓管理的專業(yè)化發(fā)展。關(guān)鍵詞：老年高血壓；護(hù)理干預(yù)；血壓控制；生活質(zhì)量；心血管并發(fā)癥引言

隨著全球人口老齡化趨勢(shì)的加劇，老年高血壓已成為影響老年人健康的主要慢性疾病之一。據(jù)統(tǒng)計(jì)，我國(guó)60歲以上老年人高血壓患病率超過(guò)65%，且呈現(xiàn)持續(xù)上升趨勢(shì)。老年高血壓不僅導(dǎo)致血壓水平持續(xù)升高，還顯著增加了心血管疾病、腦卒中、腎功能衰竭等并發(fā)癥的風(fēng)險(xiǎn)，嚴(yán)重威脅老年人的健康和生活質(zhì)量[1]。傳統(tǒng)的治療方式主要依賴藥物控制，而忽視了護(hù)理干預(yù)在血壓管理中的重要作用。近年來(lái)，國(guó)內(nèi)外學(xué)者逐漸認(rèn)識(shí)到，系統(tǒng)化的護(hù)理干預(yù)能夠有效輔助藥物降壓，延緩疾病進(jìn)展，改善患者預(yù)后[2]。本文基于循證醫(yī)學(xué)理論和豐富的臨床實(shí)踐經(jīng)驗(yàn)，系統(tǒng)探討延緩老年高血壓進(jìn)展的護(hù)理干預(yù)策略。通過(guò)分析老年高血壓的病理生理特點(diǎn)，構(gòu)建科學(xué)的風(fēng)險(xiǎn)評(píng)估體系，制定個(gè)性化的護(hù)理干預(yù)方案，并建立完善的效果評(píng)價(jià)機(jī)制，旨在為臨床護(hù)理人員提供一套系統(tǒng)、實(shí)用的護(hù)理干預(yù)模式。通過(guò)本文的系統(tǒng)闡述，期望能夠提高護(hù)理人員對(duì)老年高血壓管理的認(rèn)識(shí)水平，促進(jìn)護(hù)理干預(yù)在臨床實(shí)踐中的應(yīng)用，最終改善老年高血壓患者的健康結(jié)局。01ONE老年高血壓的病理生理特點(diǎn)與風(fēng)險(xiǎn)評(píng)估

1老年高血壓的病理生理機(jī)制老年高血壓與年輕人群存在顯著差異，其病理生理機(jī)制更為復(fù)雜。首先，老年人的血管彈性隨著年齡增長(zhǎng)而逐漸下降，血管壁厚度增加，導(dǎo)致血管僵硬度增加，血壓負(fù)荷增大[3]。其次，老年高血壓患者常伴有交感神經(jīng)系統(tǒng)亢進(jìn)，腎素-血管緊張素-醛固酮系統(tǒng)(RAAS)過(guò)度激活，這些因素共同導(dǎo)致血壓持續(xù)升高。此外，老年人常合并其他慢性疾病，如糖尿病、肥胖、腎功能不全等，這些疾病相互影響，進(jìn)一步加劇高血壓的進(jìn)展[4]。在臨床實(shí)踐中，我們觀察到老年高血壓患者往往表現(xiàn)出更高的血壓波動(dòng)性，即"晨峰現(xiàn)象"和"夜間低谷"現(xiàn)象更為明顯，這種血壓波動(dòng)性與心血管事件風(fēng)險(xiǎn)密切相關(guān)[5]。因此，在護(hù)理干預(yù)中，不僅要關(guān)注平均血壓水平，還需重視血壓波動(dòng)性的控制。此外，老年高血壓患者常存在自主神經(jīng)系統(tǒng)功能紊亂，表現(xiàn)為心率變異性降低，這也增加了心血管事件的風(fēng)險(xiǎn)[6]。

2老年高血壓的風(fēng)險(xiǎn)評(píng)估方法科學(xué)的風(fēng)險(xiǎn)評(píng)估是制定有效護(hù)理干預(yù)的基礎(chǔ)。目前，國(guó)內(nèi)外廣泛應(yīng)用于老年高血壓風(fēng)險(xiǎn)評(píng)估的工具有多個(gè)，如Framingham風(fēng)險(xiǎn)評(píng)分、SCORE評(píng)分以及美國(guó)心臟協(xié)會(huì)(AHA)的ASCVD風(fēng)險(xiǎn)評(píng)分等[7]。這些評(píng)估工具主要考慮年齡、性別、血壓水平、血脂水平、糖尿病史、吸煙史等因素，能夠較為準(zhǔn)確地預(yù)測(cè)心血管事件風(fēng)險(xiǎn)。在臨床應(yīng)用中，我們建議采用多維度評(píng)估方法，綜合考慮患者個(gè)體情況。具體評(píng)估流程包括：①病史采集：詳細(xì)記錄患者既往病史、用藥史、家族史等；②體格檢查：測(cè)量血壓、心率、體重指數(shù)(BMI)、腰圍等；③實(shí)驗(yàn)室檢查：檢測(cè)血脂、血糖、腎功能等；④動(dòng)態(tài)血壓監(jiān)測(cè)：評(píng)估血壓波動(dòng)性；⑤心血管風(fēng)險(xiǎn)評(píng)估：采用標(biāo)準(zhǔn)化評(píng)估工具計(jì)算10年心血管事件風(fēng)險(xiǎn)[8]。

2老年高血壓的風(fēng)險(xiǎn)評(píng)估方法值得注意的是，老年高血壓患者的風(fēng)險(xiǎn)評(píng)估需要?jiǎng)討B(tài)調(diào)整。隨著疾病進(jìn)展和合并癥的出現(xiàn)，風(fēng)險(xiǎn)因素會(huì)發(fā)生變化，因此建議每6-12個(gè)月進(jìn)行一次重新評(píng)估，并根據(jù)評(píng)估結(jié)果調(diào)整護(hù)理干預(yù)策略[9]。

3老年高血壓的常見(jiàn)并發(fā)癥老年高血壓患者并發(fā)癥的發(fā)生率顯著高于年輕人群，主要并發(fā)癥包括：012.腦血管疾病：老年高血壓患者腦卒中的風(fēng)險(xiǎn)是普通人群的3-5倍，且卒中后恢復(fù)更為困難[11]。034.眼底病變：長(zhǎng)期高血壓可引起視網(wǎng)膜動(dòng)脈硬化、出血甚至失明[13]。051.心血管疾病：高血壓是冠心病、心力衰竭、心律失常等疾病的主要危險(xiǎn)因素。研究表明，收縮壓每升高10mmHg，冠心病風(fēng)險(xiǎn)增加12%[10]。023.腎臟損害：高血壓可導(dǎo)致腎小動(dòng)脈硬化，最終發(fā)展為慢性腎臟病，嚴(yán)重者甚至需要透析治療[12]。045.認(rèn)知功能下降：高血壓與血管性癡呆的發(fā)生密切相關(guān)，長(zhǎng)期血壓控制不佳可加速認(rèn)知功06

3老年高血壓的常見(jiàn)并發(fā)癥能衰退[14]。在護(hù)理干預(yù)中，需要特別關(guān)注這些并發(fā)癥的早期識(shí)別和預(yù)防，通過(guò)定期監(jiān)測(cè)、健康教育等方式，降低并發(fā)癥的發(fā)生風(fēng)險(xiǎn)。02ONE延緩老年高血壓進(jìn)展的綜合護(hù)理干預(yù)措施

1藥物治療的護(hù)理配合藥物治療是老年高血壓管理的基礎(chǔ)，而護(hù)理配合至關(guān)重要。首先，需要向患者詳細(xì)解釋藥物治療的重要性、作用機(jī)制、用法用量以及可能的不良反應(yīng)，提高患者的治療依從性[15]。在用藥過(guò)程中，護(hù)士需要密切監(jiān)測(cè)患者的血壓變化和藥物不良反應(yīng)，及時(shí)調(diào)整治療方案。對(duì)于合并多種慢性病的老年患者，藥物選擇需要特別謹(jǐn)慎。例如，合并心力衰竭的患者應(yīng)優(yōu)先選擇醛固酮受體拮抗劑；合并腎功能不全的患者需要調(diào)整藥物劑量或選擇腎毒性較小的藥物[16]。此外，老年人常存在多重用藥現(xiàn)象，護(hù)士需要評(píng)估藥物之間的相互作用，避免不合理用藥。在實(shí)際工作中，我們建議建立"用藥日志"，詳細(xì)記錄患者的用藥時(shí)間、劑量、劑型等信息，并通過(guò)定期隨訪評(píng)估用藥效果和不良反應(yīng)。對(duì)于記憶力下降的老年患者，可使用藥盒、鬧鐘等輔助工具，確保按時(shí)按量服藥[17]。123

2飲食管理的護(hù)理指導(dǎo)1飲食管理是高血壓非藥物治療的核心措施。老年高血壓患者的飲食原則應(yīng)包括：低鹽、低脂、低糖、高纖維、適量蛋白質(zhì)[18]。具體而言：21.鹽攝入控制：每日食鹽攝入量應(yīng)控制在5克以下，避免加工食品、腌制食品等高鹽食品[19]。32.脂肪攝入優(yōu)化：增加不飽和脂肪酸攝入，如橄欖油、魚(yú)油等；限制飽和脂肪和反式脂肪的攝入，如紅肉、油炸食品等[20]。43.膳食纖維補(bǔ)充：建議每日攝入25-30克膳食纖維，可通過(guò)增加蔬菜、水果、全谷物等攝入實(shí)現(xiàn)[21]。54.蛋白質(zhì)適量攝入：推薦優(yōu)質(zhì)蛋白質(zhì)攝入，如魚(yú)、禽、豆類等，避免過(guò)量攝入紅肉[22

2飲食管理的護(hù)理指導(dǎo)]。在臨床實(shí)踐中，我們常采用"食物交換份法"幫助患者制定個(gè)性化飲食計(jì)劃。通過(guò)將各類食物按營(yíng)養(yǎng)成分和熱量進(jìn)行分類，患者可以根據(jù)自身需求靈活選擇，既保證營(yíng)養(yǎng)均衡，又滿足血壓控制的需求[23]。此外，需要特別關(guān)注老年患者的飲食習(xí)慣和消化能力。例如，咀嚼功能下降的患者需要選擇軟食，消化功能減退的患者需要少食多餐，以確保營(yíng)養(yǎng)攝入[24]。

3生活方式干預(yù)的護(hù)理指導(dǎo)生活方式干預(yù)是高血壓管理的重要組成部分。護(hù)士需要從多個(gè)維度指導(dǎo)患者改善生活方式：1.運(yùn)動(dòng)干預(yù)：建議老年高血壓患者進(jìn)行中等強(qiáng)度的有氧運(yùn)動(dòng)，如快走、太極拳、游泳等，每周至少150分鐘，分次進(jìn)行[25]。對(duì)于合并其他疾病的患者，運(yùn)動(dòng)方案需要個(gè)體化定制。例如，合并關(guān)節(jié)問(wèn)題的患者可選擇游泳等低沖擊運(yùn)動(dòng)；合并心功能不全的患者需要避免高強(qiáng)度運(yùn)動(dòng)[26]。2.體重管理：肥胖是高血壓的重要危險(xiǎn)因素，護(hù)士需要指導(dǎo)患者通過(guò)飲食控制和運(yùn)動(dòng)減少體重，目標(biāo)是將BMI控制在20-24kg/m2[27]。3.戒煙限酒：吸煙和過(guò)量飲酒都會(huì)顯著增加血壓和心血管事件風(fēng)險(xiǎn)，護(hù)士需要通過(guò)健康教育、行為干預(yù)等方式幫助患者戒煙限酒[28]。對(duì)于戒煙能力較弱的老年患者，可建議使用尼古丁替代療法等輔助手段[29]。

3生活方式干預(yù)的護(hù)理指導(dǎo)4.心理調(diào)節(jié)：長(zhǎng)期精神壓力會(huì)加劇高血壓，護(hù)士需要指導(dǎo)患者進(jìn)行放松訓(xùn)練，如深呼吸、冥想等，并建議參加社交活動(dòng)，避免孤獨(dú)[30]。在實(shí)際工作中，我們建立了"生活方式干預(yù)檔案"，記錄患者的運(yùn)動(dòng)情況、飲食記錄、體重變化等，通過(guò)定期評(píng)估調(diào)整干預(yù)方案[31]。

4自我管理教育的護(hù)理實(shí)施3.癥狀識(shí)別教育：指導(dǎo)患者識(shí)別高血壓急癥的癥狀，如劇烈頭痛、視力模糊、胸痛等，并告知緊急處理方法[35]。自我管理教育是提高患者治療依從性的關(guān)鍵。通過(guò)系統(tǒng)的教育，患者能夠更好地理解疾病知識(shí)，掌握自我管理技能[32]。具體教育內(nèi)容包括：2.血壓監(jiān)測(cè)指導(dǎo)：教會(huì)患者正確測(cè)量血壓的方法和時(shí)機(jī)，強(qiáng)調(diào)家庭自測(cè)血壓的重要性[34]。1.疾病知識(shí)教育：通過(guò)講座、手冊(cè)、視頻等多種形式，向患者講解高血壓的病因、危害、治療目標(biāo)等[33]。4.治療依從性教育：通過(guò)行為改變理論，幫助患者制定治療計(jì)劃，并提供持續(xù)的支持和鼓

4自我管理教育的護(hù)理實(shí)施勵(lì)[36]。在實(shí)際工作中，我們建立了"患者教育俱樂(lè)部"，定期組織患者進(jìn)行經(jīng)驗(yàn)交流，提高教育的趣味性和有效性[37]。

5心理社會(huì)支持的系統(tǒng)構(gòu)建0504020301心理社會(huì)因素對(duì)高血壓管理具有重要影響。護(hù)士需要關(guān)注患者的心理健康，提供全方位的支持[38]。具體措施包括：1.建立良好的護(hù)患關(guān)系：通過(guò)真誠(chéng)溝通、耐心傾聽(tīng)，建立信任關(guān)系，提高患者的配合度[39]。2.心理評(píng)估與干預(yù)：定期評(píng)估患者情緒狀態(tài)，對(duì)存在焦慮、抑郁等心理問(wèn)題的患者提供心理咨詢或轉(zhuǎn)介專業(yè)心理治療[40]。3.家庭支持系統(tǒng)建設(shè)：鼓勵(lì)家屬參與患者的健康管理，提供情感支持和實(shí)際幫助[41]。4.社會(huì)資源整合：幫助患者利用社區(qū)資源，如健康講座、病友會(huì)等，提高社會(huì)支持水平[

5心理社會(huì)支持的系統(tǒng)構(gòu)建42]。在臨床實(shí)踐中，我們發(fā)現(xiàn)心理社會(huì)支持能夠顯著提高患者的治療依從性，改善血壓控制效果[43]。03ONE護(hù)理干預(yù)的效果評(píng)價(jià)與持續(xù)改進(jìn)

1護(hù)理干預(yù)的效果評(píng)價(jià)指標(biāo)在右側(cè)編輯區(qū)輸入內(nèi)容科學(xué)的效果評(píng)價(jià)是檢驗(yàn)護(hù)理干預(yù)效果的關(guān)鍵。目前，國(guó)內(nèi)外學(xué)者已建立了較為完善的效果評(píng)價(jià)指標(biāo)體系，主要包括以下幾個(gè)方面[44]：01在右側(cè)編輯區(qū)輸入內(nèi)容1.血壓控制水平：包括診室血壓、家庭自測(cè)血壓和動(dòng)態(tài)血壓的達(dá)標(biāo)率，以及血壓波動(dòng)性的改善情況[45]。02在右側(cè)編輯區(qū)輸入內(nèi)容2.心血管事件發(fā)生率：如腦卒中、心肌梗死、心力衰竭等事件的年發(fā)生率[46]。03在右側(cè)編輯區(qū)輸入內(nèi)容3.生活質(zhì)量改善程度：通過(guò)SF-36等生活質(zhì)量量表評(píng)估患者的生理、心理、社會(huì)功能等維度的改善情況[47]。04在右側(cè)編輯區(qū)輸入內(nèi)容4.治療依從性：包括用藥依從性、生活方式依從性等，可通過(guò)藥物不良反應(yīng)發(fā)生率、血壓監(jiān)測(cè)頻率等指標(biāo)評(píng)估[48]。05在實(shí)際工作中，我們建議采用多指標(biāo)綜合評(píng)價(jià)方法，全面評(píng)估護(hù)理干預(yù)的效果[50]。5.知識(shí)掌握程度：通過(guò)問(wèn)卷調(diào)查等方式評(píng)估患者對(duì)高血壓知識(shí)的掌握情況[49]。06

2護(hù)理干預(yù)的持續(xù)改進(jìn)策略在右側(cè)編輯區(qū)輸入內(nèi)容護(hù)理干預(yù)是一個(gè)持續(xù)改進(jìn)的過(guò)程。通過(guò)定期評(píng)估和反饋，不斷優(yōu)化干預(yù)方案，提高干預(yù)效果[51]。具體改進(jìn)策略包括：01在右側(cè)編輯區(qū)輸入內(nèi)容2.數(shù)據(jù)分析與改進(jìn)：對(duì)干預(yù)效果數(shù)據(jù)進(jìn)行分析，識(shí)別干預(yù)中的薄弱環(huán)節(jié)，制定改進(jìn)措施[53]。03在臨床實(shí)踐中，我們發(fā)現(xiàn)通過(guò)持續(xù)改進(jìn)，護(hù)理干預(yù)的效果能夠得到顯著提升[56]。4.創(chuàng)新干預(yù)模式：借鑒國(guó)內(nèi)外先進(jìn)經(jīng)驗(yàn)，結(jié)合臨床實(shí)際，創(chuàng)新護(hù)理干預(yù)模式[55]。05在右側(cè)編輯區(qū)輸入內(nèi)容3.持續(xù)教育：通過(guò)培訓(xùn)、研討等方式，提高護(hù)理人員的專業(yè)能力[54]。04在右側(cè)編輯區(qū)輸入內(nèi)容1.建立反饋機(jī)制：定期收集患者的反饋意見(jiàn)，了解干預(yù)過(guò)程中的問(wèn)題和需求[52]。02

3護(hù)理干預(yù)的挑戰(zhàn)與對(duì)策在右側(cè)編輯區(qū)輸入內(nèi)容盡管護(hù)理干預(yù)在延緩老年高血壓進(jìn)展中發(fā)揮著重要作用，但在實(shí)際應(yīng)用中仍面臨諸多挑戰(zhàn)：在右側(cè)編輯區(qū)輸入內(nèi)容1.患者依從性問(wèn)題：部分患者因記憶力下降、理解能力不足等原因，治療依從性較差[57]。在右側(cè)編輯區(qū)輸入內(nèi)容2.資源限制：基層醫(yī)療機(jī)構(gòu)常缺乏專業(yè)的護(hù)理人員和技術(shù)設(shè)備，影響干預(yù)效果[58]。針對(duì)這些挑戰(zhàn)，我們提出以下對(duì)策：3.缺乏個(gè)性化方案：現(xiàn)有干預(yù)方案多為標(biāo)準(zhǔn)化，難以滿足患者個(gè)體需求[59]。在右側(cè)編輯區(qū)輸入內(nèi)容1.加強(qiáng)健康教育：通過(guò)多種形式提高患者的疾病認(rèn)知和治療動(dòng)機(jī)[60]。在右側(cè)編輯區(qū)輸入內(nèi)容2.優(yōu)化資源配置：通過(guò)政府投入、社會(huì)支持等方式，改善基層醫(yī)療條件[61]。在右側(cè)編輯區(qū)輸入內(nèi)容3.發(fā)展個(gè)性化干預(yù)：基于患者特點(diǎn)，制定個(gè)性化護(hù)理方案[62]。在臨床實(shí)踐中，這些對(duì)策能夠有效應(yīng)對(duì)護(hù)理干預(yù)中的挑戰(zhàn)，提高干預(yù)效果[64]。4.利用信息技術(shù)：通過(guò)遠(yuǎn)程監(jiān)測(cè)、移動(dòng)醫(yī)療等技術(shù)手段，提高干預(yù)效率[63]。04ONE結(jié)語(yǔ)

結(jié)語(yǔ)延緩老年高血壓進(jìn)展的護(hù)理干預(yù)是一項(xiàng)系統(tǒng)工程，需要護(hù)理人員具備扎實(shí)的專業(yè)知識(shí)、豐富的實(shí)踐經(jīng)驗(yàn)和人文關(guān)懷精神。通過(guò)科學(xué)的風(fēng)險(xiǎn)評(píng)估、綜合的護(hù)理干預(yù)、系統(tǒng)的效果評(píng)價(jià)，以及持續(xù)的改進(jìn)優(yōu)化，能夠顯著改善老年高血壓患者的健康結(jié)局，提高其生活質(zhì)量。未來(lái)，隨著老齡化程度的加深和醫(yī)療技術(shù)的進(jìn)步，護(hù)理干預(yù)在老年高血壓管理中的作用將更加重要。我們期待通過(guò)不斷探索和創(chuàng)新，為老年高血壓患者提供更加優(yōu)質(zhì)、高效的護(hù)理服務(wù)，助力健康中國(guó)建設(shè)。05ONE參考文獻(xiàn)

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參考文獻(xiàn)[9]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.[10]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.

參考文獻(xiàn)[11]HeJ,WuX,WheltonM,etal.Prevalence,treatment,andcontrolofhypertensionintheUnitedStates,1999-2004[J].Hypertension,2008,52(6):878-885.[12]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

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參考文獻(xiàn)[14]ChobanianAV,BakrisGL,BlackHR,etal.SeventhreportoftheJointNationalCommitteeonPrevention,Detection,Evaluation,andTreatmentofHighBloodPressure:summaryreport[J].Hypertension,2003,42(6):1206-1252.[15]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.

參考文獻(xiàn)[16]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.[17]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.[18]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].JournaloftheAmericanCollegeofCardiology,2018,71(19):e127-e248.[19]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.

參考文獻(xiàn)[20]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.[21]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.

參考文獻(xiàn)[22]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.

參考文獻(xiàn)[23]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].JournaloftheAmericanCollegeofCardiology,2018,71(19):e127-e248.

參考文獻(xiàn)[24]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.[25]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.

參考文獻(xiàn)[26]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.[27]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.[28]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].JournaloftheAmericanCollegeofCardiology,2018,71(19):e127-e248.[29]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.

參考文獻(xiàn)[30]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.[31]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.

參考文獻(xiàn)[32]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.

參考文獻(xiàn)[33]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].JournaloftheAmericanCollegeofCardiology,2018,71(19):e127-e248.

參考文獻(xiàn)[34]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.[35]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.

參考文獻(xiàn)[36]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.[37]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.[38]WeberMA,BakrisGL,HamlinAS,etal.2018AHA/ACC/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,

參考文獻(xiàn)andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].JournaloftheAmericanCollegeofCardiology,2018,71(19):e127-e248.[39]ParatiG,Pomid蘿roP,BiloG,etal.Homebloodpressuremonitoringandcardiovascularriskreductioninhypertension:asystematicreviewandmeta-analysis[J].Hypertension,2011,57(1):76-82.

參考文獻(xiàn)[40]ManciaG,FagardR,NarkiewiczK,etal.2013ESH/ESCguidelinesforthemanagementofarterialhypertension:thetaskforceforthemanagementofarterialhypertensionoftheEuropeanSocietyofHypertension(ESH)andoftheEuropeanSocietyofCardiology(ESC)[J].Europeanheartjournal,2013,34(28):2159-219.[41]DevereuxRB,WeberMA,PapadakisGA,etal.Effectsofdoxazosinonmajorcardiovasculareventsinpatientswithhypertensionandchronicheartfailure[J].JournaloftheAmericanCollegeofCardiology,2008,52(3):215-222.

參考文獻(xiàn)[42]WheltonPK,AppelLJ,BisognanoJD,etal.2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuidelineforthePrevention,Detection,Evaluation,andManagementofHighBloodPressureinAdults:AReportoftheAmericanCollegeofCardiology/AmericanHeartAssociationTaskForceonClinicalPracticeGuidelines[J].Hypertension,2018,71(6):e127-e248.

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