ADA 指南.doc

Treatment
● Patients with a systolic blood pressure
130–139 mmHg or a diastolic blood
pressure 80–89 mmHg may be given
lifestyle therapy alone for a maximum
of 3 months, and then if targets are not
achieved, patients should be treated
with the addition of pharmacological
agents. (E)
● Patients with more severe hypertension
(systolic blood pressure _140 mmHg
or diastolic blood pressure _90
mmHg) at diagnosis or follow-up
should receive pharmacologic therapy
in addition to lifestyle therapy. (A)
● Lifestyle therapy for hypertension consists
of weight loss if overweight,
DASH-style dietary pattern including
reducing sodium and increasing potassium
intake, moderation of alcohol intake,
and increased physical activity.
(B)
● Pharmacologic therapy for patients
with diabetes and hypertension should
be paired with a regimen that includes
either an ACE inhibitor or an angiotensin
II receptor blocker (ARB). If one
class is not tolerated, the other should
be substituted. If needed to achieve
blood pressure targets, a thiazide diuretic
should be added to those with an
estimated glomerular filtration rate
(GFR) (see below) _30 ml _ min/
m2 and a loop diuretic for those with an
estimated GFR _30 ml _ min/ m2.
(C)
● Multiple drug therapy (two or more
agents at maximal doses) is generally
required to achieve blood pressure targets.
(B)
● If ACE i