Page 114 - Phòng Và Điều Trị Bệnh Đái Tháo Đường

Chan doan THA khi huyet ap toi da > 140mmHg
hoac/va huyet ap toi thieu > 90mmHg. Tuy nhtfng

ngiidi co huyet ap toi da 120-139mmHg hoac huyet
ap toi thieu 80-89mmHg khong phai la nhiing ngtfdi
co huyet ap binh thtfdng theo tieu chuan chan doan
mdi, nhtfng theo thdi gian phan Idn nhtfng ngtfdi nay
se tien trien tdi THA thtfc stf va dieu quan trong khac
ntfa la theo thong ke nguy cd benh mach mau gia
tang d mtfc huyet ap rat thap (>115/75mmHg), ctf
tang mdi 20/10mmHg so vdi mtfc tren nguy cd tii
vong do benh tim mach se tang gap doi. Do vay dieu
tri THA tich ctfc d ngtfdi DTD phai dtfdc coi la muc
tieu tfu tien sd" 1.

Neu huyet ap toi da giam lOmmHg se giam dtfdc
12% nguy cd cac bien chtfng lien quan tdi benh DTD,
giam 15% nguy cd tii vong do DTD, giam 11% nguy cd
bi nhoi mau cd tim, giam 13% nguy cd bien chtfng vi
mach. [Tight blood pressure control and risk of
macrouascular complications in typ 2 diabetes:

UKPDS 38. United Kingdom Prospective Diabetes
Study. BMJ 1998; 317:703-713].
Nghien ctfu tren 1501 ngtfdi THA ngtfdi ta nhan
thay: tai bien mach mau nao giam 30% d nhom nghien
ctfu vdi muc tieu huyet ap toi thieu < 80mmHg so vdi
nhom nghien ctfu cd huyet ap toi thieu <90mmHg.

[Effects of intensive bood pressure lowering and low
dose aspirin in patient with hypertetion: principal
results of the hypertention Optimal Treatement (HOT)
randomised trial. Lancet 1998; 351:1755-1762].

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