成人糖尿病患者血压管理专家共识

2021-02-04 上海市医学会 上海医学.2021.44(1):8-18.

本共识建议成人糖尿病患者高血压的诊断标准为收缩压&ge;140mmHg(1mmHg=0.133kPa)和(或)舒张压&ge;90mmHg,血压控制目标为<130/80mmHg,老年患者或血压不易

中文标题:

成人糖尿病患者血压管理专家共识

发布机构:

上海市医学会

发布日期:

2021-02-04

简要介绍:

本共识建议成人糖尿病患者高血压的诊断标准为收缩压≥140mmHg(1mmHg=0.133kPa)()舒张压≥90mmHg,血压控制目标为<130/80mmHg,老年患者或血压不易控制的患者可放宽至<140/90mmHg。生活方式干预是糖尿病患者血压管理的基础,应贯穿于治疗的始终。成人糖尿病患者的血压≥140/90mmHg时应给予药物降压治疗;如果血压≥160/100mmHg,建议起始即予两种药物联用。ACEIARB、二氢吡啶类CCB和噻嗪类利尿剂为糖尿病患者的一线抗高血压药物;伴白蛋白尿的糖尿病患者降压治疗首选ACEIARB;不伴白蛋白尿的糖尿病患者降压治疗首选ACEIARB,次选二氢吡啶类CCB、噻嗪类利尿剂。单药治疗不达标的患者应及时启动联合治疗。合并高血压的糖尿病患者应管理好高血糖、高血脂等心血管疾病危险因素。应优化降糖治疗方案,在无禁忌证时降糖治疗方案中宜包含钠-葡萄糖协同转运蛋白2抑制剂;如不能使用钠-葡萄糖协同转运蛋白2抑制剂,在有适应证的情况下使用胰高糖素样肽-1受体激动剂。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1187395, encodeId=55da118e39550, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/949453D13700D5D5E2170BDB0CBBEB81/100, createdBy=66e32451407, createdName=胡国宏, createdTime=Sun Jan 23 09:40:08 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182160, encodeId=2047118216093, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d826447882, createdName=咩咩爱吃桃, createdTime=Sat Jan 08 11:21:00 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1083022, encodeId=2844108302264, content=非常实用 学习到了 , beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=12cb5438026, createdName=ms4000000901131801, createdTime=Wed Dec 22 11:08:49 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1082735, encodeId=40281082e35f5, content=非常及时,很实用,必须点赞, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ccpIPibkaTQdQ6y88yDtEPU4sh7lOzQCoopxc1IF22vpUQnkfEo0ibeARK8byaF0OTCQp7uthiczsETh7ROyYYnaw/132, createdBy=81f25308124, createdName=肾达人, createdTime=Tue Dec 21 22:16:21 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1080472, encodeId=238710804e291, content=非常实用的共识, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8e11491929, createdName=lium1873, createdTime=Wed Dec 15 23:33:24 CST 2021, time=2021-12-15, status=1, ipAttribution=)]
    2022-01-23 胡国宏
  2. [GetPortalCommentsPageByObjectIdResponse(id=1187395, encodeId=55da118e39550, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/949453D13700D5D5E2170BDB0CBBEB81/100, createdBy=66e32451407, createdName=胡国宏, createdTime=Sun Jan 23 09:40:08 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182160, encodeId=2047118216093, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d826447882, createdName=咩咩爱吃桃, createdTime=Sat Jan 08 11:21:00 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1083022, encodeId=2844108302264, content=非常实用 学习到了 , beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=12cb5438026, createdName=ms4000000901131801, createdTime=Wed Dec 22 11:08:49 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1082735, encodeId=40281082e35f5, content=非常及时,很实用,必须点赞, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ccpIPibkaTQdQ6y88yDtEPU4sh7lOzQCoopxc1IF22vpUQnkfEo0ibeARK8byaF0OTCQp7uthiczsETh7ROyYYnaw/132, createdBy=81f25308124, createdName=肾达人, createdTime=Tue Dec 21 22:16:21 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1080472, encodeId=238710804e291, content=非常实用的共识, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8e11491929, createdName=lium1873, createdTime=Wed Dec 15 23:33:24 CST 2021, time=2021-12-15, status=1, ipAttribution=)]
    2022-01-08 咩咩爱吃桃

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1187395, encodeId=55da118e39550, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/949453D13700D5D5E2170BDB0CBBEB81/100, createdBy=66e32451407, createdName=胡国宏, createdTime=Sun Jan 23 09:40:08 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182160, encodeId=2047118216093, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d826447882, createdName=咩咩爱吃桃, createdTime=Sat Jan 08 11:21:00 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1083022, encodeId=2844108302264, content=非常实用 学习到了 , beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=12cb5438026, createdName=ms4000000901131801, createdTime=Wed Dec 22 11:08:49 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1082735, encodeId=40281082e35f5, content=非常及时,很实用,必须点赞, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ccpIPibkaTQdQ6y88yDtEPU4sh7lOzQCoopxc1IF22vpUQnkfEo0ibeARK8byaF0OTCQp7uthiczsETh7ROyYYnaw/132, createdBy=81f25308124, createdName=肾达人, createdTime=Tue Dec 21 22:16:21 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1080472, encodeId=238710804e291, content=非常实用的共识, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8e11491929, createdName=lium1873, createdTime=Wed Dec 15 23:33:24 CST 2021, time=2021-12-15, status=1, ipAttribution=)]
    2021-12-22 ms4000000901131801

    非常实用 学习到了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1187395, encodeId=55da118e39550, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/949453D13700D5D5E2170BDB0CBBEB81/100, createdBy=66e32451407, createdName=胡国宏, createdTime=Sun Jan 23 09:40:08 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182160, encodeId=2047118216093, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d826447882, createdName=咩咩爱吃桃, createdTime=Sat Jan 08 11:21:00 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1083022, encodeId=2844108302264, content=非常实用 学习到了 , beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=12cb5438026, createdName=ms4000000901131801, createdTime=Wed Dec 22 11:08:49 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1082735, encodeId=40281082e35f5, content=非常及时,很实用,必须点赞, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/ccpIPibkaTQdQ6y88yDtEPU4sh7lOzQCoopxc1IF22vpUQnkfEo0ibeARK8byaF0OTCQp7uthiczsETh7ROyYYnaw/132, createdBy=81f25308124, createdName=肾达人, createdTime=Tue Dec 21 22:16:21 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1080472, encodeId=238710804e291, content=非常实用的共识, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8e11491929, createdName=lium1873, createdTime=Wed Dec 15 23:33:24 CST 2021, time=2021-12-15, status=1, ipAttribution=)]
    2021-12-21 肾达人

    非常及时,很实用,必须点赞

    0

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    2021-12-15 lium1873

    非常实用的共识

    0

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