p.3 抽出テキスト

6.4.1. Sex-specific non-traditional cardiovascular disease risk modifiers ......................................................................................................... 3939 6.4.2. Non-traditional cardiovascular disease risk modifiers shared by men and women .................................................................... 3940 6.4.3. Additional risk decision tests ..................................................... 3941 6.5. Summary of the cardiovascular disease risk stratification approach for allocating blood pressure treatment .......................... 3941 7. Diagnosing hypertension and investigating underlying causes ...... 3943 7.1. Screening for hypertension ................................................................ 3943 7.2. Confirming the diagnosis of hypertension .................................. 3943 7.3. Communicating the diagnosis ........................................................... 3944 7.4. Baseline assessment and diagnostic approach ........................... 3944 7.4.1. Medical history, medication history, and physical examination ................................................................................................... 3944 7.4.2. Drug adherence and persistence with treatment ............ 3945 7.4.3. Routine and optional tests .......................................................... 3945 7.4.3.1. The kidneys ............................................................................... 3947 7.4.3.2. The heart ................................................................................... 3947 7.4.3.3. The arteries .............................................................................. 3948 7.4.4. Genetic testing ................................................................................. 3948 7.5. Resistant hypertension: definition and diagnosis ...................... 3948 7.6. Secondary hypertension: when to screen/further investigations ..................................................................................................... 3950 7.6.1. General considerations ................................................................ 3950 7.6.2. Primary aldosteronism ................................................................. 3950 7.6.3. Renovascular hypertension ........................................................ 3951 7.6.4. Obstructive sleep apnoea syndrome ..................................... 3951 7.6.5. Phaeochromocytoma/paraganglioma ..................................... 3954 8. Preventing and treating elevated blood pressure and hypertension ........................................................................................................... 3954

8.1. Prevention strategies in early life ..................................................... 3954 8.2. Non-pharmacological interventions ............................................... 3954 8.2.1. Dietary sodium and potassium intake ................................... 3954 8.2.1.1. Sodium ........................................................................................ 3954 8.2.1.2. Potassium ................................................................................... 3955 8.2.2. Physical activity and exercise ..................................................... 3956 8.2.3. Weight reduction and diet ......................................................... 3957 8.2.4. Alcohol, coffee, and soft drinks ................................................ 3957 8.2.5. Smoking ............................................................................................... 3957 8.3. Pharmacological interventions .......................................................... 3958 8.3.1. Treatment strategy to reduce adverse cardiovascular disease outcomes ........................................................................................ 3958 8.3.2. Drug classes with evidence on clinical outcomes in the target population ......................................................................................... 3958 8.3.3. New therapies with blood pressure-lowering properties that await supportive evidence from cardiovascular outcomes trials prior to guideline endorsement and routine use in hypertension ................................................................................................. 3959 8.3.4. Drug combinations and up-titrating strategies .................. 3959 8.3.5. A practical algorithm for intensive, effective, and tolerable blood pressure lowering with drug therapy, including considerations around single-pill combinations ............................. 3959 8.3.6. Timing of blood pressure-lowering drug treatment ....... 3962 8.4. Selecting patients for pharmacological blood pressurelowering treatment ........................................................................................ 3962 8.5. Intensity of blood pressure-lowering therapy and ideal treatment targets ............................................................................................ 3964 8.5.1. Expected degree of blood pressure reduction with approved drugs ............................................................................................ 3964 8.5.2. The ideal target of blood pressure-lowering treatment 3964 8.5.3. Personalizing treatment strategies .......................................... 3965 8.5.4. Duration and monitoring of drug therapy ........................... 3966 8.6. Device-based blood pressure lowering ........................................ 3966 8.6.1. Catheter-based renal denervation .......................................... 3966 8.6.2. Other devices ................................................................................... 3968 8.7. Unintended and potentially harmful consequences of blood pressure lowering and implications for treatment targets ........... 3968 8.7.1. Adverse effects of blood pressure-lowering medications 3968 8.7.1.1. Symptomatic adverse effects ............................................ 3968 8.7.1.2. Renal effects ............................................................................. 3968 8.7.1.3. Erectile dysfunction ............................................................... 3968 8.7.2. Pill burden and non-adherence ................................................. 3968 8.7.3. Potentially harmful consequences of blood pressure lowering for frail older people .............................................................. 3968 8.7.4. Clinical inertia in blood pressure lowering .......................... 3968 9. Managing specific patient groups or circumstances .......................... 3969 9.1. Young adulthood (18–40 years) ...................................................... 3969 9.1.1. Definition and epidemiology ...................................................... 3969 9.1.2. Secondary hypertension in young adulthood ..................... 3969 9.1.3. Measurement and management of blood pressure in young adults .................................................................................................. 3969 9.2. Pregnancy ................................................................................................... 3969 9.2.1. Definition and epidemiology ...................................................... 3969 9.2.2. Classifying hypertension in pregnancy ................................... 3969 9.2.3. Measuring blood pressure in pregnancy ............................... 3970 9.2.4. Investigating hypertension in pregnancy ............................... 3970 9.2.5. Preventing hypertension and pre-eclampsia ....................... 3970 9.2.6. Treatment initiation and blood pressure targets .............. 3970 9.2.7. Managing mild hypertension in pregnancy (office blood pressure 140–159/90–109 mmHg) ..................................................... 3970 9.2.8. Managing severe hypertension in pregnancy (>160/110 mmHg) ............................................................................................................. 3971 9.2.9. Managing blood pressure post-partum ................................. 3971 9.2.10. Risk of recurrence of hypertensive disorders in a subsequent pregnancy .............................................................................. 3971 9.3. Very old age (≥85 years), frailty, multimorbidity, and polypharmacy .................................................................................................... 3971 9.3.1. Definition of frailty ......................................................................... 3971 9.3.2. Randomized controlled trials of blood pressure lowering in frail older patients .................................................................................. 3972 9.3.3. Starting blood pressure-lowering treatment in very old or frail patients ................................................................................................... 3973 9.3.4. Maintaining blood pressure lowering in very old or frail patients ............................................................................................................ 3973 9.4. Isolated systolic and diastolic hypertension ................................ 3973 9.4.1. Definition of isolated systolic hypertension ........................ 3973 9.4.2. Isolated systolic hypertension, risk factors, and ageing .. 3973 9.4.3. Isolated systolic hypertension in young adults ................... 3974 9.4.4. Isolated diastolic hypertension .................................................. 3974 9.5. Orthostatic hypotension with supine hypertension ............... 3974 Downloaded from academic.oup.com/eurheartj/article/45/38/3912/7741010 by guest on 07 October 2026