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Kohonneen verenpaineen lääkehoidon yleinen tavoitetaso

Näytönastekatsaukset
Antti Jula
10.9.2020

Näytön aste: A

Kohonneen verenpaineen vähimmäishoitotavoite on vastaanottomittausten perusteella alle 140/90 mmHg.

Satunnaistettujen lumekontrolloitujen tutkimusten «Psaty BM, Smith NL, Siscovick DS ym. Health outcom...»1, «Wright JM, Lee CH, Chambers GK. Systematic review ...»2, «Collins R, Peto R, MacMahon S ym. Blood pressure, ...»3, «Prevention of stroke by antihypertensive drug trea...»4, «Staessen JA, Fagard R, Thijs L ym. Randomised doub...»5 tutkittavien lukumäärillä painotettu hoitoa edeltävä verenpaine oli systolista hypertensiota sairastavilla keskimäärin 172/81 mmHg ja muilla keskimäärin 165/98 mmHg (60-vuotiailla tai sitä vanhemmilla keskimäärin 188/95 mmHg, nuoremmilla keskimäärin 160/100 mmHg). Vastaavasti hoidonaikainen verenpainetaso oli systolista hypertensiota sairastavilla keskimäärin 146/73 mmHg ja muilla keskimäärin noin 145/85 mmHg (60-vuotiailla tai sitä vanhemmilla keskimäärin 156/81 mmHg ja nuoremmilla keskimäärin noin 138/86 mmHg).

Hoitoa edeltävä verenpainetaso kuvaa näyttöön perustuvaa hoidon aloitustasoa ja hoidonaikainen verenpainetaso näyttöön perustuvaa verenpaineen hoidon tavoitetasoa.

Näytön taso diastolisesta hoitotavoitteesta < 90 mmHg alle 60-vuotiailla ja sitä vanhemmilla on vahva A perustuen seuraaviin tutkimuksiin: «Psaty BM, Smith NL, Siscovick DS ym. Health outcom...»1, «Wright JM, Lee CH, Chambers GK. Systematic review ...»2, «Collins R, Peto R, MacMahon S ym. Blood pressure, ...»3, «Prevention of stroke by antihypertensive drug trea...»4, «Staessen JA, Fagard R, Thijs L ym. Randomised doub...»5, «MRC trial of treatment of mild hypertension: princ...»6, «The Australian therapeutic trial in mild hypertens...»7, «Five-year findings of the hypertension detection a...»8, «Five-year findings of the hypertension detection a...»9, «Effects of treatment on morbidity in hypertension....»10 ja «Hansson L, Zanchetti A, Carruthers SG ym. Effects ...»11.

Näytön taso systolisesta hoitotavoitteesta < 140 mmHg on alle 60-vuotiailla vahva A perustuen seuraaviin tutkimuksiin: «Psaty BM, Smith NL, Siscovick DS ym. Health outcom...»1, «Wright JM, Lee CH, Chambers GK. Systematic review ...»2, «Collins R, Peto R, MacMahon S ym. Blood pressure, ...»3, «Prevention of stroke by antihypertensive drug trea...»4, «Staessen JA, Fagard R, Thijs L ym. Randomised doub...»5, «MRC trial of treatment of mild hypertension: princ...»6, «The Australian therapeutic trial in mild hypertens...»7, «Five-year findings of the hypertension detection a...»8, «Five-year findings of the hypertension detection a...»9, «Effects of treatment on morbidity in hypertension....»10 ja «Hansson L, Zanchetti A, Carruthers SG ym. Effects ...»11.

60-vuotiailla ja sitä vanhemmilla näytön taso systolisesta hoitotavoitteesta < 150 mmHg on vahva A perustuen seuraaviin tutkimuksiin: «Staessen JA, Fagard R, Thijs L ym. Randomised doub...»5, «Beckett NS, Peters R, Fletcher AE ym. Treatment of...»12, «Prevention of stroke by antihypertensive drug trea...»13, «JATOS Study Group. Principal results of the Japane...»14, «Ogihara T, Saruta T, Rakugi H ym. Target blood pre...»15 ja «Verdecchia P, Staessen JA, Angeli F ym. Usual vers...»16.

60-vuotiailla ja sitä vanhemmilla näytön taso systolisesta hoitotavoitteesta < 140 mmHg on asiantuntija-arvioon perustuva (näytön taso D).

  • Tutkimuksen laatu: tasokas
  • Sovellettavuus suomalaiseen väestöön: hyvä

Kirjallisuutta

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