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<meta name="description" content="日本高血圧学会が総力を挙げて編集・執筆した，高血圧の実地診療にかかわるすべての医師・医療従事者に向けた診療ガイドブック．高血圧は日本に4,300万人いると推定されている最も多い生活習慣病である．本書は「高血圧治療ガイドライン2019（JSH2019）」に準拠し，エビデンスに基づく診療方針をふまえつつ，診断から評価，治療の一連の流れはもちろん患者指導のポイントまで，日常診療における対応をわかりやすく">

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		<h1 class="catchCopy">日本高血圧学会が総力を挙げて編集・執筆！高血圧診療にかかわるすべての医師・医療従事者必携の実践的なガイドブック!!</h1>
		

		<h1 class="title titleWidth">高血圧診療ガイド2020<span class="version"></span></h1>
		

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					編集：日本高血圧学会 高血圧診療ガイド2020作成委員会
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				<ul class="property"><li class="disc">B5判・120頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2060-7</li><li class="disc">2020年4月4日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">日本高血圧学会が総力を挙げて編集・執筆した，高血圧の実地診療にかかわるすべての医師・医療従事者に向けた診療ガイドブック．高血圧は日本に4,300万人いると推定されている最も多い生活習慣病である．本書は「高血圧治療ガイドライン2019（JSH2019）」に準拠し，エビデンスに基づく診療方針をふまえつつ，診断から評価，治療の一連の流れはもちろん患者指導のポイントまで，日常診療における対応をわかりやすく簡潔にまとめた実践的な一冊となっている．</section><section class="preface">序　文<br>　日本高血圧学会は2000年に『高血圧治療ガイドライン2000年版（JSH2000）』を発刊して以降，約5年ごとに改訂を行っており，2019年4月に第5版となる『高血圧治療ガイドライン2019（JSH2019）』を発刊した．JSH2019 では，17項目のClinical Question（CQ）を作成，Systematic Review（SR）を行って，多くのエビデンスの評価，統合後に推奨文を作成するなど，いままで以上にエビデンスを重視したガイドラインとなった．<br>　しかしながら，実地診療の現場ではエビデンスが不十分な課題や指針をそのまま適用できない患者，病態などが多く存在する．『高血圧診療ガイド2020』は，JSH2019で提示されたエビデンスに基づく診療方針を踏まえつつ，実地診療でどのように対応したらよいかについて簡潔にまとめたものである．JSH2019の作成委員に加えて実地医家も委員として参加し，「高血圧の診断と疫学」から「二次性高血圧のスクリーニング」，「臓器障害の評価」，「治療計画の策定」，「生活習慣の修正」，「降圧薬治療」と一連の流れを実地診療の目線でまとめ，「治療抵抗性高血圧」，「合併症を有する高血圧の管理」，「女性の高血圧」についても解説した．さらに，「専門医に紹介するポイント」，「患者指導のポイント」と実地診療にとって重要なテーマを取り上げ，高血圧診療に携わる多くの医療従事者に利用していただくことを念頭に置いて作成した．巻末には降圧薬一覧を掲載し，薬剤のクラスごとの特徴や副作用に加えて，個別の薬剤の高血圧以外の適応や特記事項についても記載した．<br>　高血圧は日本に4,300万人いると推定されている最も多い生活習慣病である．医師はもとより，看護師，保健師，薬剤師，管理栄養士などさまざまな職種の医療従事者が，それぞれの専門の立場で高血圧の一次予防，重症化予防を目ざして活動するための手引書として本書を活用していただければ幸いである．<br><br>2020年3月<br>日本高血圧学会 高血圧診療ガイド2020 作成委員会<br>委員長　土橋卓也</section><section class="indexes">1　高血圧の診断と疫学<br>　A　血圧とは <br>　B　血圧計<br>　C　血圧の評価：診察室血圧と診察室外血圧<br>　D　高血圧の診断 <br>　　診察室血圧／診察室外血圧／白衣高血圧／仮面高血圧<br>　E　高血圧の疫学 <br>　　高血圧の予後と管理状況／日本人の高血圧の特徴<br>　F　高血圧への対策<br><br>2 二次性高血圧のスクリーニング <br>　A　二次性高血圧総論 <br>　　レニンとアルドステロンの評価／身体所見／血液一般検査／病歴<br>　B　腎血管性高血圧 <br>　C　腎実質性高血圧<br>　D　内分泌性高血圧 <br>　　原発性アルドステロン症／クッシング症候群・サブクリニカルクッシング症候群／褐色細胞腫・パラガングリオーマ／その他の内分泌性高血圧<br>　E　睡眠時無呼吸症候群<br>　F　薬剤誘発性高血圧<br><br>3　臓器障害の評価 <br>　A　脳・眼底 <br>　　認知機能検査／抑うつ状態評価試験／眼底検査／CTもしくはMRI<br>　B　心・血管<br>　　問診／診察／検査<br>　C　腎<br>　　腎機能検査／推算糸球体濾過量（eGFR）の計算／試験紙法による尿蛋白の解釈と対処／その他の腎機能検査<br>　D　臓器障害評価at a glance<br><br>4 治療計画の策定　高血圧の管理および治療の基本方針<br>　A　治療の基本<br>　B　初診時の血圧レベル別の高血圧管理計画<br>　C　降圧目標 <br>　D　降圧薬治療の原則<br>　E　高齢者高血圧<br><br>5　生活習慣の修正 <br>　A　食事療法 <br>　　食塩制限／その他の栄養素<br>　B　適正体重の維持<br>　C　運動療法 <br>　D　節　酒<br>　E　禁　煙<br>　F　その他 <br>　G　複合的な生活習慣の修正 <br><br>6　降圧薬治療<br>　A　降圧薬選択の基本<br>　　第一選択薬／降圧薬の使い方／薬剤相互作用／降圧薬の減量と中止<br>　B　併用療法と配合剤 <br>　　併用療法のメリット／併用療法における降圧薬の組み合わせ／配合剤<br>　C　各種降圧薬の特徴と主な副作用<br>　　Ca拮抗薬／ARB／ACE阻害薬／直接的レニン阻害薬（DRI）／利尿薬／β遮断薬／α遮断薬／MR拮抗薬／中枢性交感神経抑制薬／古典的な血管拡張薬<br><br>7　治療抵抗性高血圧<br>　A　定義と頻度 <br>　B　治療抵抗性高血圧の要因と評価<br>　C　治療抵抗性高血圧への対策<br>　D　腎交感神経デナベーション<br><br>8　合併症を有する高血圧の管理　脳血管障害，心疾患，腎疾患，糖尿病 <br>　A　脳血管障害 <br>　　超急性期・急性期の降圧療法／慢性期の降圧療法／無症候性脳血管障害<br>　B　心疾患<br>　　心肥大／安定冠動脈疾患／心不全／心房細動<br>　C　腎疾患<br>　　CKDの定義／CKDを合併する高血圧の病態／CKDを合併する高血圧の治療<br>　D　糖尿病<br>　　高血圧と2型糖尿病／糖尿病合併高血圧の診療／耐糖能の評価／降圧目標／降圧薬の選択<br><br>9　女性の高血圧 <br>　A　若年女性にみられる二次性高血圧<br>　B　妊娠高血圧症候群（HDP）分類と治療<br>　　分類／治療／妊娠中の降圧薬<br>　C　妊娠時の減塩は推奨されるか <br>　　妊娠時の生理学的変化／6g/日未満の減塩を妊娠高血圧の非薬物治療として推奨しない理由<br>　D　授乳期に投与できる降圧薬 <br>　　授乳期の薬剤投与の考え方／授乳婦と降圧薬<br>　E　更年期の高血圧と女性の高血圧<br>　　更年期の高血圧の特徴／女性の高血圧の特徴<br><br>10　専門医に紹介するポイント<br>　A　専門医に関する情報と紹介の仕方<br>　　専門医に関する情報／紹介のタイミング／紹介に際して<br>　B　専門医への紹介を強く勧める病態とタイミング<br>　　二次性高血圧を疑った場合／治療抵抗性高血圧／高血圧緊急症および切迫症／妊娠高血圧症候群<br>　C　専門医への相談を勧めるケース<br>　　臓器障害の悪化時／降圧薬の副作用／血圧変動<br><br>11　患者指導のポイント　すべての診断・治療は，医療者の言葉を添えて<br>　A　医師-患者関係の構築<br>　　医師-患者関係の構築のために／受診を阻害する要因を把握／協働共有意思決定（shared decision making）／患者が理解できる言葉を選択する<br>　B　指導・説明のポイント<br>　　疾患に関する説明／治療に関する説明<br><br>付　録　降圧薬一覧 <br><br>索　引</section></article>
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