Abstract from:Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets:A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians
2017-04-04 17:25:27AmirQaseemMDPhDMHATimothyWiltMDMPHRobertRichMD
Frontiers of Nursing 2017年4期
Amir Qaseem,MD,PhD,MHA,Timothy J.Wilt,MD,MPH,Robert Rich,MD,
Linda L.Humphrey,MD,MPH,Jennifer Frost,MD,Mary Ann Forciea,MD,for the Clinical Guidelines Committee of the American College of Physicians,the Commission on Health of the Public and Science of the American Academy of Family Physicians*
from:Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets:A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians☆
Amir Qaseem,MD,PhD,MHA,Timothy J.Wilt,MD,MPH,Robert Rich,MD,
Linda L.Humphrey,MD,MPH,Jennifer Frost,MD,Mary Ann Forciea,MD,for the Clinical Guidelines Committee of the American College of Physicians,the Commission on Health of the Public and Science of the American Academy of Family Physicians*
A R T I C L E I N F O
Article history:
Available online 28 October 2017
Description:The American College of Physicians(ACP)and the American Academy of Family Physicians(AAFP)jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older.
Methods:This guideline is based on a systematic review of published randomized,controlled trials for primary outcomes and observational studies for harms only(identified through EMBASE,the Cochrane Database of Systematic Reviews,MEDLINE,and Clinical Trials.gov),from database inception through January 2015.The MEDLINE search was updated through September 2016.Evaluated outcomes included all-cause mortality,morbidity and mortality related to stroke,major cardiac events(fatal andnonfatal myocardialinfarction and sudden cardiac death),and harms.This guideline grades the evidence and recommendations using the GRADE(Grading of Recommendations Assessment,Development,and Evaluation)method.
Target Audience and Patient Population:The target audience for this guideline includes all clinicians,and the target patient population includes all adults aged 60 years or older with hypertension.
Recommendation 1:ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mmHg to achieve a target systolic blood pressure of less than 150 mmHg to reduce the risk for mortality,stroke,and cardiac events.(Grade:strong recommendation,high-quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.
Recommendation 2:ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk for recurrent stroke.(Grade:weak recommendation,moderate-quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of thebenefits and harms of specific blood pressure targets with the patient.
Recommendation 3:ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk,based on individualized assessment,to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk for stroke or cardiac events.(Grade:weak recommendation,low quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.
https://doi.org/10.1016/j.cnre.2017.10.008
2095-7718/?2017 Shanxi Medical Periodical Press.Publishing services by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).☆A(yù)nn Intern Med.2017;166:430-437.https://doi.org/10.7326/M16-1785.This article was published at Annals.org on 17 January 2017.Check the original full-text from www.acponline.org.
Peer review under responsibility of Shanxi Medical Periodical Press.
*This paper,written by Amir Qaseem,MD,PhD,MHA;Timothy J.Wilt,MD,MPH;Robert Rich,MD;Linda L.Humphrey,MD,MPH;Jennifer Frost,MD;and Mary Ann Forciea,MD,was developed for the Clinical Guidelines Committee of the American College of Physicians(ACP)and the Commission on Health of the Public and Science of the American Academy of Family Physicians(AAFP).Individuals who served on the ACP Clinical Guidelines Committee from initiation of the project untilits approval were Mary Ann Forciea,MD?(Chair);Nick Fitterman,MD(Vice Chair)?;Michael J.Barry,MD?;Cynthia Boyd,MD,MPH?;Carrie A.Horwitch,MD,MPH?;Linda L.Humphrey,MD,MPH?;Alfonso Iorio,MD,PhD?;Devan Kansagara,MD,MCR?;Scott Manaker,MD,PhD?;Robert M.McLean,MD?;Sandeep Vijan,MD,MS?;and Timothy J.Wilt,MD,MPH?.Members of the AAFP's Commission on Health of the Public and Science were Patricia Czapp,MD(Chair)?;Ada Denise Stewart,MD?;David T.O'Gurek,MD?;Joseph L.Perez,MD,MBA?;Margot L.Savoy,MD,MPH?;Kenneth W.Lin,MD,MPH?;Jason M.Matuszak,MD?;Ranit Mishori,MD,MHS?;Daron W.Gersch,MD?;Clare A.Hawkins,MD,MSc?;Beulette Y.Hooks,MD?;Robyn Liu,MD,MPH?;Shannon Dowler,MD?;Shani Muhammad,MD?;Tobie-Lynn Smith,MD,MPH?;James Stevermer,MD?;Carolyn Gaughan?;Vivian Jiang,MD?;and Aisha Harris?.Approved by the ACP Board of Regents on 16 July 2016.Approved by the AAFP Board of Directors on 20 July 2016.
?Author(participated in discussion and voting).
?Nonauthor contributor(participated in discussion but not voting).
How to cite this article:Qaseem A,Wilt TJ,Rich R,et al.Abstract from:Pharmacologic treatment of hypertension in adults aged 60 years orolder tohigherversus lower blood pressuretargets:A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians.Chin Nurs Res.2017;4:211-212.https://doi.org/10.1016/j.cnre.2017.10.008
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2017-04-04 17:25:27AmirQaseemMDPhDMHATimothyWiltMDMPHRobertRichMD
Frontiers of Nursing 2017年4期
Amir Qaseem,MD,PhD,MHA,Timothy J.Wilt,MD,MPH,Robert Rich,MD,
Linda L.Humphrey,MD,MPH,Jennifer Frost,MD,Mary Ann Forciea,MD,for the Clinical Guidelines Committee of the American College of Physicians,the Commission on Health of the Public and Science of the American Academy of Family Physicians*
from:Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets:A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians☆
Amir Qaseem,MD,PhD,MHA,Timothy J.Wilt,MD,MPH,Robert Rich,MD,
Linda L.Humphrey,MD,MPH,Jennifer Frost,MD,Mary Ann Forciea,MD,for the Clinical Guidelines Committee of the American College of Physicians,the Commission on Health of the Public and Science of the American Academy of Family Physicians*
A R T I C L E I N F O
Article history:
Available online 28 October 2017
Description:The American College of Physicians(ACP)and the American Academy of Family Physicians(AAFP)jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older.
Methods:This guideline is based on a systematic review of published randomized,controlled trials for primary outcomes and observational studies for harms only(identified through EMBASE,the Cochrane Database of Systematic Reviews,MEDLINE,and Clinical Trials.gov),from database inception through January 2015.The MEDLINE search was updated through September 2016.Evaluated outcomes included all-cause mortality,morbidity and mortality related to stroke,major cardiac events(fatal andnonfatal myocardialinfarction and sudden cardiac death),and harms.This guideline grades the evidence and recommendations using the GRADE(Grading of Recommendations Assessment,Development,and Evaluation)method.
Target Audience and Patient Population:The target audience for this guideline includes all clinicians,and the target patient population includes all adults aged 60 years or older with hypertension.
Recommendation 1:ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mmHg to achieve a target systolic blood pressure of less than 150 mmHg to reduce the risk for mortality,stroke,and cardiac events.(Grade:strong recommendation,high-quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.
Recommendation 2:ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk for recurrent stroke.(Grade:weak recommendation,moderate-quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of thebenefits and harms of specific blood pressure targets with the patient.
Recommendation 3:ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk,based on individualized assessment,to achieve a target systolic blood pressure of less than 140 mmHg to reduce the risk for stroke or cardiac events.(Grade:weak recommendation,low quality evidence).ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.
https://doi.org/10.1016/j.cnre.2017.10.008
2095-7718/?2017 Shanxi Medical Periodical Press.Publishing services by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).☆A(yù)nn Intern Med.2017;166:430-437.https://doi.org/10.7326/M16-1785.This article was published at Annals.org on 17 January 2017.Check the original full-text from www.acponline.org.
Peer review under responsibility of Shanxi Medical Periodical Press.
*This paper,written by Amir Qaseem,MD,PhD,MHA;Timothy J.Wilt,MD,MPH;Robert Rich,MD;Linda L.Humphrey,MD,MPH;Jennifer Frost,MD;and Mary Ann Forciea,MD,was developed for the Clinical Guidelines Committee of the American College of Physicians(ACP)and the Commission on Health of the Public and Science of the American Academy of Family Physicians(AAFP).Individuals who served on the ACP Clinical Guidelines Committee from initiation of the project untilits approval were Mary Ann Forciea,MD?(Chair);Nick Fitterman,MD(Vice Chair)?;Michael J.Barry,MD?;Cynthia Boyd,MD,MPH?;Carrie A.Horwitch,MD,MPH?;Linda L.Humphrey,MD,MPH?;Alfonso Iorio,MD,PhD?;Devan Kansagara,MD,MCR?;Scott Manaker,MD,PhD?;Robert M.McLean,MD?;Sandeep Vijan,MD,MS?;and Timothy J.Wilt,MD,MPH?.Members of the AAFP's Commission on Health of the Public and Science were Patricia Czapp,MD(Chair)?;Ada Denise Stewart,MD?;David T.O'Gurek,MD?;Joseph L.Perez,MD,MBA?;Margot L.Savoy,MD,MPH?;Kenneth W.Lin,MD,MPH?;Jason M.Matuszak,MD?;Ranit Mishori,MD,MHS?;Daron W.Gersch,MD?;Clare A.Hawkins,MD,MSc?;Beulette Y.Hooks,MD?;Robyn Liu,MD,MPH?;Shannon Dowler,MD?;Shani Muhammad,MD?;Tobie-Lynn Smith,MD,MPH?;James Stevermer,MD?;Carolyn Gaughan?;Vivian Jiang,MD?;and Aisha Harris?.Approved by the ACP Board of Regents on 16 July 2016.Approved by the AAFP Board of Directors on 20 July 2016.
?Author(participated in discussion and voting).
?Nonauthor contributor(participated in discussion but not voting).
How to cite this article:Qaseem A,Wilt TJ,Rich R,et al.Abstract from:Pharmacologic treatment of hypertension in adults aged 60 years orolder tohigherversus lower blood pressuretargets:A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians.Chin Nurs Res.2017;4:211-212.https://doi.org/10.1016/j.cnre.2017.10.008
- Frontiers of Nursing的其它文章
- A study of clinical psychological nursing research hotspots in China and variation trends based on word frequency analysis and visualization analysis☆
- A study on clinical nursing research trends and hotspots based on bibliometric analysis☆
- Current research status and research hotspots in Chinese geriatric medicine:Data retrieved from the Chinese Journal of Geriatrics☆
- Effectiveness of flipped classrooms in nursing education:Systematic review and meta-analysis
- Clinical assessment indicators of postpartum hemorrhage:A systematic review☆
- GUIDE FOR AUTHORS