On May 12, the research results conference of “Blood pressure treatment and placebo-controlled clinical trials in Chinese population without cardiovascular and cerebrovascular diseases, diabetes, and nephropathy” was held online. Experts pointed out that blood pressure in normal blood pressure The high value range (systolic blood pressure 130-139 mmHg/diastolic blood pressure 80-89 mmHg), individuals who have not had serious diseases such as cardiovascular and cerebrovascular diseases, diabetes, kidney disease, tumors, etc., are not recommended to take antihypertensive drugs. It is the best choice for such people to control blood pressure through a healthy lifestyle.
2017, the American Heart Association guidelines define hypertension by 14 The Hg column was changed to 130/80 mm Hg, which expanded the management of hypertensive diseases and attracted attention from all walks of life. Do people with blood pressure lower than 140/90 mmHg need to control blood pressure with antihypertensive drugs to prevent or reduce the occurrence of cardiovascular and cerebrovascular diseases? Professor Zhang Xinhua, chairman of the World Hypertension Federation and executive director of the China Normal and High Value Clinical Trial Research Collaborative Group, introduced that adjusting medication strategies is not only a simple change in diagnosis and treatment standards, but also whether it can improve human health. to benefit.
In order to prove the actual benefits of taking antihypertensive drugs for people without cardiovascular and cerebrovascular diseases, diabetes or kidney disease in the normal high blood pressure range, the researchers conducted a “normal high blood pressure range for Chinese population”. Blood pressure without cardiovascular and cerebrovascular disease, diabetes, nephropathy, antihypertensive treatment and placebo-controlled clinical trial (CHINOM). Professor Zhang Xinhua introduced that the CHINOM study is a randomized controlled, partially open multi-center clinical trial study. The study divided 10,624 subjects into 4 treatment groups. placebo treatment. The primary endpoint of the CHINOM study was a composite of cardiovascular disease (fatal or non-fatal stroke, death from cardiovascular disease). Additional endpoints included: new-onset hypertension (systolic BP ≥140 mmHg/diastolic BP ≥90 mmHg), new-onset diabetes, transient cerebral ischemia, angina pectoris, hospitalization for heart failure, peripheral vascular disease, tumor, renal Functional impairment, all-cause death. The study found that among the Chinese population aged 45-79 with blood pressure in the high normal range, individuals with more than one cardiovascular disease risk factor and no cardiovascular and cerebrovascular disease, kidney disease or diabetes, taking antihypertensive drugs will not reduce blood pressure. The risk of cardiovascular and cerebrovascular diseases does not increase or decrease the risk of other cardiovascular diseases, renal impairment, tumors, and all-cause mortality. And the above results were similar in different antihypertensive drug groups (angiotensin II receptor antagonists, diuretics, and reserpine compound preparations). The study shows that individuals with blood pressure in the high normal range and without serious diseases such as cardiovascular and cerebrovascular diseases, diabetes, kidney disease, and tumors are not recommended to take antihypertensive drugs. At the same time, research also suggests that individuals with blood pressure in the high-normal range may be the best choice to control blood pressure through a healthy lifestyle. The results of the CHINOM study support the recommendations in the current guidelines for hypertension management in China, the World Health Organization and other international organizations: individuals who have not had cardiovascular and cerebrovascular diseases, diabetes, kidney disease and other serious diseases, if the blood pressure is between 130 and 139 mmHg/ 80-89 mm Hg range, blood pressure should be controlled through a healthy lifestyle.
Expert Opinion
Lifetime Honorary Chairman of China Hypertension League, China Normal Liu Lisheng, director of the high-value clinical trial research project: The results of this study are significant, and provide clinical debates on whether the threshold for hypertension treatment needs to be lowered, and whether a larger population should be included in the scope of antihypertensive treatment. Evidence-based evidence. Huo Yong, Vice Chairman of China Cardiovascular Health Alliance and Director of the Advisory Committee of the China Normal and High Value Clinical Trial Research Collaborative Group: This research has important guiding significance for the precise stratified prevention and control of hypertension today. For high-risk groups, blood pressure should be strengthened; for low-risk groups, blood pressure control should be emphasized through a healthy lifestyle.
Wang Jiguang, Chairman of China Hypertension Alliance and Chairman of China Normal High-value Clinical Trial Research Project Endpoint Determination and Data Safety Committee: The results of this study will update the guidelines for the treatment of hypertension at home and abroad Provide important clinical evidence, which will have a profound impact on the prevention and treatment of hypertension in the future. Zhang Yuqing, Secretary General of China Hypertension League and Coordinator of China High-Normal Clinical Trial Research Collaborative Group: After more than ten years of hard work, the CHINOM study has provided important evidence for the intervention of high-normal blood pressure at home and abroad. It also made important explorations for subsequent related research.
Text: Health News reporter Hu Bin
Editor: Yu Mengfei, Zheng Yingfan
Review: Xu Bingnan, Yan Yan
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