Türk popülasyonunda obstrüktif uyku apne sendromunda rol oynayan antropometrik ölçümlerin belirlenmesi
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Tarih
2019
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info:eu-repo/semantics/openAccess
Özet
Öz: Türk Hipertansiyon Uzlaşı Raporu, Avrupa ve Amerika kay- naklı uluslararası kılavuzları ülkemiz klinik pratiğine uyarla- mak ve hipertansiyon hastaları ile ilgilenen hekimlere temel bir başvuru kaynağı olabilecek pratik bir metin oluşturmak amacıyla ilk kez 2015 yılında hazırlandı. Hipertansiyon- la ilgili beş temel hipertansiyon derneğinin oluşturduğu bir komisyon tarafından hazırlanan bu rapor, kabul gördü ve yaygın olarak kullanılmaya başlandı. 2015 yılından sonra hipertansiyon literatüründeki yeni klinik çalışmalar ve gün- cellenen uluslararası kılavuzlar, Türk Hipertansiyon Uzlaşı Raporu’nun da güncellenmesi ihtiyacını doğurdu. Güncelle- nen 2019 raporunda kan basıncı düzeyleri Normal, Artmış, Evre 1 ve Evre 2 hipertansiyon olarak sınıflandırıldı. Sekon- der hipertansiyon için yeni bir bölüm eklendi. İlaç tedavisine dört grup ilaçtan [diüretikler, kalsiyum kanal blokerleri, anjiyo- tensin dönüştürücü enzim (ACE) inhibitörleri ve anjiyotensin reseptör blokerleri (ARB)] herhangi biri veya kombinasyonu (ACE inhibitörü ve ARB kombinasyonu hariç) ile başlanabile- ceği belirtildi. Beta-blokerlerin ise sadece atriyal fibrilasyon, kalp yetersizliği ve koroner arter hastalığı gibi hastalıklarda ilk seçenek tedavi olarak kullanılabileceği vurgulandı. Kan basıncı düzeyi ?150/90 mmHg olanlarda hipertansiyon teda- visine öncelikle kombinasyon tedavisiyle başlanması öneril- di. Hipertansiyon tedavisinde yaş ve eşlik eden hastalıkların varlığına göre kan basıncı hedef değerleri yeniden tanım- landı. Hipertansiyon tedavi algoritması yenilendi; artmış kan basıncı grubuna da (sistolik kan basıncı, 120–139 mmHg ve diyastolik kan basıncı, 80–89 mmHg) risk temelli yaklaşım ile ilaç tedavisi başlanabileceği önerisi getirildi. Yaşı 80 ve üze- rinde olan kişilerde ilaç tedavisi başlanması için eşik klinik sistolik kan basıncı düzeyi 160 mmHg’den ?150 mmHg’ye düşürüldü. Hipertansiyon tedavisinde özel hasta gruplarına gebelik ve laktasyon bölümü eklendi. Önceki raporda olduğu gibi, bu güncellemede de hipertansiyonu bütün yönleri ile ele alan kapsamlı bir rapordan çok, klinikte en sık görülen du- rumlara yönelik pratik uygulama önerilerinin sunulması he- deflendi. Bu rapor hastaların çoğu için kanıta dayalı öneriler sunmakla birlikte, hastadan hastaya farklılıkların olabileceği ve böyle durumlarda hekimin iyi bir klinik değerlendirmeye göre hastalara bireyselleştirilmiş yaklaşımlarda bulunması gerektiği unutulmamalıdır.
Öz: The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and Ameri- can international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hyperten- sion. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta- blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level ?150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pres- sure (systolic blood pressure: 120–139 mmHg, diastolic blood pressure: 80–89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to ?150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommen- dations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation
Öz: The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and Ameri- can international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hyperten- sion. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta- blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level ?150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pres- sure (systolic blood pressure: 120–139 mmHg, diastolic blood pressure: 80–89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to ?150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommen- dations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation
Açıklama
Anahtar Kelimeler
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
N/A
Scopus Q Değeri
Q3
Cilt
67
Sayı
4
Künye
AYDOĞDU S,GÜLER K,BAYRAM F,ALTUN B,DERİCİ Ü,ABACI A,TÜKEK T,SABUNCU T,ARICI M,ERDEM Y,ÖZİN B,ŞAHİN İ,ERTÜRK Ş,BİTİGEN A,TOKGÖZOĞLU L (2019). Türk Hipertansiyon Uzlaşı Raporu 2019. Türk Kardiyoloji Derneği Arşivi, 47(6), 535 - 546. Doi: 10.5543/tkda.2019.62565
