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We Dropped the Reflex Hammer on Hypertension 20 Years Ago.
JAMA Neurology ( IF 29.0 ) Pub Date : 2020-04-01 , DOI: 10.1001/jamaneurol.2020.0070
Conrado J Estol 1
Affiliation  

To the Editor The authors of this Viewpoint1 should be commended for calling attention to the overdue and under-recognized importance of hypertension, which accounts for 13% of total deaths, as a major treatable cause of cognitive decline and cardiovascular mortality and morbidity. For the last 20 years, we have studied hypertension at our neurology clinic in Argentina where we teach young neurologists that blood pressure (BP) measurement is the most valuable medical procedure and found that 59% of patients had a BP greater than 140/90 mm Hg during their first visit.2 Hypertension was not previously diagnosed in 50%, and in 80% of those treated, BP was uncontrolled. The prevalence of hypertension ranged from 40% to 80% in patients with headache, neuromuscular disease, Parkinson disease, dementia, and stroke. We referred patients with hypertension to their primary physician to find that when they returned to our clinic they still had hypertension. In a second part of the study, we initiated and adjusted hypertension treatment at the neurology clinic.3 Of 1464 neurology consults, 1009 patients (69%) had hypertension at the first visit. Only 76 of 508 known patients with hypertension (15%) were controlled. Among 544 patients with hypertension who returned for follow-up, BP decreased from an average 155/93 mm Hg to 143/86 and in 222 (40%) reached normal values. There was a significant difference in the rate of patients with controlled hypertension favoring those treated at the neurology clinic compared with those treated elsewhere.



中文翻译:

我们在20年前放弃了对高血压的反射锤。

致编辑该观点1的作者呼吁人们注意高血压的过早和未充分认识的重要性,高血压占总死亡人数的13%,是造成认知能力下降,心血管疾病死亡率和发病率的主要原因。在过去的20年中,我们在阿根廷的神经内科诊所研究了高血压,在那里我们教会年轻的神经病学家血压测量是最有价值的医疗程序,发现59%的患者的BP大于140/90 mm汞在他们的第一次访问。2先前没有诊断出高血压的比例为50%,而在80%的高血压患者中,血压未得到控制。头痛,神经肌肉疾病,帕金森病,痴呆和中风患者的高血压患病率为40%至80%。我们将高血压患者转诊给他们的主治医师,以发现他们回到我们的诊所后仍然患有高血压。在研究的第二部分中,我们在神经病学诊所开始并调整了高血压治疗。3在1464位神经病学咨询医师中,有1009例患者(69%)在初诊时患有高血压。508名已知的高血压患者中只有76名(15%)得到控制。在544名接受随访的高血压患者中,血压从平均155/93毫米汞柱降至143/86,有222例(40%)血压恢复正常。与其他地方的患者相比,控制高血压的患者对神经内科诊所治疗的偏爱率有显着差异。

更新日期:2020-04-01
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