偏高的血壓毫無疑問需要治療－VA研究結果
對於ACA／AHA新版血壓指南的爭議，焦點在140vs130
鑒於看到有不少網友實例，血壓早超過140不少，生活方式改變降壓效果微弱時仍然不願藥物治療。。。我接著發這篇研究給大家參考。這是60年代的一個裏程碑式對照研究，結果非常清晰，毫無模棱兩可的灰色地域：偏高與嚴重的高血壓毫無疑問需要治療。
The Veterans Administration (VA) cooperative study on antihypertensive agents was a major milestone achieved in medicine. This was the first adequately powered placebo-controlled, RCT of antihypertensive therapy (15). The phase 1 of the study examined active treatment (hydrochlorothiazide, reserpine, and hydralazine) vs. placebo in 143 veterans with severe hypertension (diastolic blood pressure 115–129 mmHg) and achieved an average fall of blood pressure by 43/30 mmHg in the treated group. The recruitment started in 1964 and average follow-up was about 1.5 years. The results of the study showed clear morbidity and mortality benefit, most remarkably in reduction in progression to accelerated/malignant hypertension in the treatment group.
Study summary:
Total patients – 70 in each group
BP achieved – 91.6 vs. 119.7
Events-
– Death: 4 in control, 0 in treatment group
– Morbid Events: 27 in control, 2 in Rx group
Morbid events included progression to malignant hypertension as evidenced by fundal hemorrhage, CVA, MI, heart failure, and dissecting aneurysm.
高血壓是一種沉默殺手，可以沒有不適症狀。血壓真的高了，不治療後果可能很嚴重(比如上麵的黑斜段落所列)，需要認真對待，不要以僥幸心理忽略。至於多高為偏高需要治療，請和醫生谘詢。指南是針對全民大人口的，醫生治療病人是都是針對一個一個的個體來治的。西醫裏，隻要你以生活方式改變真能取得確實而明顯的療效，沒有醫生會叫你去吃藥。
