The media interprets the driving force behind the downward adjustment of diagnostic criteria for hypertension. Let's take a look with me.
Red star depth | 130/80 or 140/90? The Debate of "Normal High Value" Behind "Hypertension" of 200 Million People
According to Oriental IC
Red Star journalist Hu Wuyang reports from Beijing.
Editor Qiu Tian
According to chinese journal of cardiology WeChat official account 165438+ 10/3, the Clinical Practice Guide of Hypertension in China (hereinafter referred to as the guide) was issued. The guideline suggests that the diagnostic threshold of hypertension in adults in China should be lowered from ≥ 140/90mmHg to ≥ 130/80 mmHg. The guideline was jointly formulated by the National Cardiovascular Center, the Chinese Medical Doctor Association, the Hypertension Committee of the Chinese Medical Doctor Association, the Cardiovascular Branch of the Chinese Medical Association, and the Hypertension Committee of the Cross-Strait Medical and Health Exchange Association. After the relevant news was reported by the media, it caused widespread concern.
165438+1October15th, National Health Commission announced that at present, the national diagnostic criteria for adult hypertension have not been adjusted. Guides and knowledge issued by professional organizations, trade associations and individuals are the research results of experts, and are not used as national disease diagnosis standards.
Red Star News reporter found that at present, the pre-release link of the guide in Chinese Journal of Cardiology has expired. According to the official WeChat account information mentioned above, the guide will be officially published in the issue 1 1 of Chinese Journal of Cardiology 2022 on1on October 24th.
Will the standard change affect the geometry? According to the Guide, the national survey data show that among the adults aged 65,438+08 and above in China, SBP (systolic blood pressure) is 65,438+030 ~ 65,438+039 mmHg and/or DBP (diastolic blood pressure) is 80~89 mmHg, accounting for 23.2%, and the estimated total number is nearly 243 million. According to the guideline, according to the starting standard of antihypertensive drug therapy recommended by the latest international guideline, among adults aged 35 and above in China, 22.7% of people with SBP 130~ 139 mmHg and/or DBP80~89 mmHg need antihypertensive drug therapy, and the total number is estimated to be 39.9 million.
Chen Hui, a professor and chief physician of Fujian Institute of Cardiovascular Diseases, learned about the formulation of the guidelines. After the publication of the Guide, she also had an exchange with Cai Jun, the founder and chief expert of the Guide and a professor at Fuwai Hospital of China Academy of Medical Sciences of the National Cardiovascular Center. She told the Red Star journalist that the original intention of the guidelines was good, but the revision of the clinical guidelines involved a wide range and required a response from the National Health and Family Planning Commission. Research shows that strengthening blood pressure reduction is good for human body, especially for the elderly, so we hope to pay attention to normal high-value people.
However, Chen Hui believes that the revision of hypertension standards is a bit radical, which may go out of shape in the implementation process, leading to the doubling of the number of people taking drugs and increasing the burden of personal and national medical insurance. She believes that we should return to strengthening lifestyle intervention for normal high-value people.
Differences in diagnostic criteria
There have long been different voices in the world.
National Health Commission pointed out that regarding the diagnostic criteria of hypertension, the publicity and education points, prevention and treatment guidelines and clinical pathways issued by the national health administrative department in 2005, 20 10, 20 17 were all clear: the diagnostic criteria of hypertension in adults are: blood pressure exceeds 140/90mmHg for three consecutive times in the same day.
According to CBN, at present, China Hypertension Union, Hypertension Branch of China Health Care Association for the Promotion of International Exchanges, Hypertension Branch of China Geriatrics Association, National Health Commission Key Laboratory of Hypertension Diagnosis and Treatment, and Shanghai Hypertension Research Institute, which have not participated in the above guidelines, have jointly submitted statements to National Health Commission, expounding relevant positions and giving relevant suggestions.
The Red Star News reporter noticed that the prevention and treatment guideline issued on 20 10 is the "Guidelines for Prevention and Treatment of Hypertension in China". The latest version of this guide was revised in 20 18. The authors are China Hypertension Prevention and Control Guidelines Revision Committee, Hypertension Alliance (China), Cardiovascular Branch of Chinese Medical Association, Hypertension Professional Committee of Chinese Medical Doctor Association, Hypertension Branch of China Medical Care International Exchange Promotion Association, and Hypertension Branch of China Geriatrics Association. Both editions are led by Liu, Dean of Fuwai Hospital of China Academy of Medical Sciences, Director of Beijing Institute of Hypertension and former President of World Hypertension Union.
According to the relevant guidelines at home and abroad, the standard of ≥ 160/95mmHg proposed by the World Health Organization in 1977 was changed to ≥ 140/90mmHg in 1997, which has been widely adopted by all countries in the world and has been used so far.
The guidelines of American Heart Association (ACC)/ American Heart Association (AHA) on hypertension in 20 17 took the lead in lowering the diagnostic standard of hypertension to ≥ 130/80 mmHg. However, few institutions and academic groups follow this standard. The American Diabetes Association has always adhered to the diagnostic criteria of ≥ 140/90 mmHg. The guidelines for hypertension management issued by the European Society of Cardiology (ESC)/ European Society of Hypertension (ESH) in 2018 and the international practice guidelines for hypertension issued by the International Society of Hypertension (ISH) ISH)2020 all maintain the diagnostic criteria of ≥ 140/90mmHg.
In May 2022, the Cardiology Society of Taiwan Province Province in China and the Hypertension Society of Taiwan Province Province jointly published the Guide to Hypertension in Taiwan Province Province in 2022, which lowered the diagnostic standard of hypertension to 130/80mmHg. Professor Jiang, a professor at the Veterans General Hospital of Chinese Taipei, once pointed out at a cross-strait academic seminar that with the deepening of related research, there are also differences in the setting of hypertension in the world. Different academic organizations have different antihypertensive goals, which can be roughly divided into three groups: active antihypertensive, traditional antihypertensive and passive antihypertensive.
Guo, an expert in the drafting group of the Guide and vice president of Hebei Provincial People's Hospital, wrote on the official account of personal WeChat that it is normal for different scholars and academic institutions to have different academic views. There are reasons and grounds for the downward adjustment of this standard, but its starting point is consistent with the fundamental motivation, that is, to better control blood pressure and minimize the harm of hypertension to the lives and health of Chinese residents.
People whose blood pressure is130-139/80-89 mmhg are a very noteworthy group. Guo believes that the controversy caused by the guideline is a good thing, because ordinary people can pay attention to their blood pressure health and care that they may be patients. "If so, more people will consciously take the initiative to eat less and exercise more to lose weight, quit smoking, limit alcohol and salt, stay up late regularly, relax and get enough sleep."
Definition of normal high value
Blood pressure is not a single constant value.
However, lower than the diagnostic criteria does not mean that blood pressure is normal. Normal blood pressure is usually defined as
Generally speaking, it is only recommended to start antihypertensive drug treatment for high-risk groups with SBP 130 ~ 139 mmHg internationally. Another major adjustment of the guidelines is that for people whose blood pressure is130-139mmhg/80-89mmhg with 0-2 cardiovascular risk factors, if their blood pressure is still not up to standard after lifestyle intervention for 3-6 months, it is recommended to start antihypertensive drug treatment immediately.
Chen Hui explained that human blood pressure itself is not a single constant value. The currently used 140/90mmHg is also the result of population survey. This value is suitable for most people, but for some individuals, the diagnosis of hypertension may not be valid.
Chen Hui believes that doctors should first strengthen the education of normal high-value people between 130/80mmHg and 140/90mmHg to see if it can be reversed through lifestyle intervention, which is also emphasized in the previous guide.
"Any level of hypertension, first of all, non-drug treatment, healthy lifestyle can not meet the standard and then consider drug treatment, which is a principle of hypertension treatment. However, if 130/80mmHg becomes the standard in this guide, pharmaceutical companies will take this opportunity to publicize that everyone above this standard will take medicine. This will lead to a large increase in the number of drug users, and both individuals and national medical insurance will be under pressure. " Chen Hui said.
Controversy about standard adjustment
Not only clinical research, but also national conditions should be considered.
As for the basis for lowering the standard, the recommendations in the Guide cite a number of domestic and foreign studies, indicating that based on observational research evidence, harm exists; Based on the clinical trial evidence, the intervention is effective. But then the academic circles issued different voices.
Liu, director of the Institute of Beijing Hypertension Union and former president of the World Hypertension Union, said recently that there is no high-quality evidence that drug treatment will achieve obvious benefits when the blood pressure is in the range of130 ~139 mmhg/80 ~ 89 mmhg.
Wang Jiguang, chairman of China Hypertension Alliance and professor of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, also pointed out in an interview with CBN reporter that up to now, no published randomized controlled clinical study at home and abroad has confirmed that it can benefit non-high-risk patients with blood pressure130-139/80-89 mmhg, and no study has confirmed the safety of drug treatment for these people. Wang Jiguang said that lowering the diagnostic criteria of hypertension is not only not suitable for China's national conditions, but may also cause serious health hazards to people at risk of hypotension.
The adjustment of American ACC/AHA20 17 hypertension guidelines is also controversial internationally. For example, on 20 18, the British Medical Journal (BMJ) published a cooperative study between the National Cardiovascular Center of the United States and Yale University. It is believed that if the new definition of American hypertension guidelines is used, both Chinese and American health systems will be overwhelmed and unsustainable.
Chen Hui explained that the United States lowered the standard of hypertension guidelines to 130/80mmHg, mainly because there are a large number of obese people in the United States, and the risk factors affecting hypertension have been difficult to control. In order to better meet the standard of blood pressure and reduce the complications of heart, brain and kidney, the standard of hypertension in the United States is lower than that in other countries. At the same time, this is also related to the relatively better medical resources in the United States. But this standard is too radical for other countries, and most countries are using the standard of 140/90mmHg.
From the perspective of cost-effectiveness, Zhao Dong, a professor of anzhen hospital affiliated to Capital Medical University, introduced at the press conference that most people with blood pressure levels of 130~ 139 mmHg and/or 80~89 mmHg are young and middle-aged. Lowering the diagnostic criteria embodies the concept of moving forward and strengthening initial prevention, otherwise it will miss the key opportunity to reduce the harm of cardiovascular diseases caused by hypertension. It is an important window period to reduce the adverse consequences of hypertension by lifestyle intervention for people with blood pressure130 ~139/80 ~ 89 mmhg and starting antihypertensive drug treatment when non-drug treatment fails. Although the downward adjustment of the diagnostic criteria for hypertension may lead to an increase in the cost of early treatment (based on the current national medical insurance and centralized drug procurement policy, this increase is completely affordable), in the long run, the high cost of treatment for serious complications in the future is expected to drop significantly, which is cost-effective on the whole.
The reporter has not paid attention to the basic articles or specific calculation process of the evaluation evidence of health economics given in the Guide.
Chen Hui said that China's national conditions are different from those of the United States. There are not as many obese people in China as in the United States, and normal high-value people can be treated with non-drugs. At the same time, China's medical resources are relatively insufficient, and the medical insurance affordability is limited. "The formulation of clinical guidelines should not only consider clinical research, but also consider national conditions, such as the affordability of national medical care and the health level of the people."
The share price of pharmaceutical companies once rose sharply.
Are there any benefits behind it?
The formulation of a medical guide needs to invite experts from all aspects and departments. According to the full text of the guideline, the members of the guideline working group include not only clinicians and experts in the cardiovascular field, but also experts and patient representatives in the fields of nephrology, endocrinology, urology, vascular surgery, psychiatry, epidemiology, nursing, clinical pharmacy and health economics. Red Star News reporter noticed that there are four decision makers in the external audit team.
Cai Jun, the founder of the Guide, said in an interview with the media recently that the lowering of the diagnostic threshold for hypertension was decided by the unanimous vote of 50 top experts in cardiovascular field in China. According to Economic Observer, a core member of the guideline formulation committee also said that "the vast majority of experts voted in favor".
Red Star journalists learned from relevant people that before and after the publication of the guideline, relevant discussions and symposiums were held in the domestic cardiovascular field.
On Monday165438+1October 14, the stock prices of antihypertensive drugs companies such as Huahai Pharmaceutical, Renfu Pharmaceutical and Rundu Shares rose sharply. In this regard, some netizens questioned the interests of pharmaceutical companies.
The Red Star reporter learned that in terms of funding sources, the Guide indicated that the funds needed for the preparation came from the project of the Disease Prevention and Control Bureau of the National Health and Wellness Committee (T202 1-ZC02) and the Medical and Health Science and Technology Innovation Project of China Academy of Medical Sciences (202 1-I2M- 1-007). The funds are mainly used to pay for labor, materials, travel and conference expenses, and the suggestions in the guide are not affected by the funds.
In terms of conflict of interest, the guide points out that all authors declare that there is no conflict of interest. The core members of the above-mentioned guideline formulation committee interviewed by Economic Observer Network also said that the guideline used all the research funds of its own projects and "never took a penny from pharmaceutical companies".
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Who is depressing the diagnostic criteria of hypertension?
"At present, the country has not adjusted the diagnostic criteria for adult hypertension." 165438+1October 15, the national health planning commission gave the final response on "whether the diagnostic criteria of hypertension in China have been adjusted".
The response is clear. The diagnostic standard of adult hypertension is that the blood pressure exceeds 140/90mmHg three times in a row on different days. At the same time, it is emphasized that the guidelines and knowledge published by professional organizations, trade associations and individuals are the research results of experts and are not used as national disease diagnosis standards.
165438+1October 13 The Clinical Practice Guidelines for Hypertension in China (hereinafter referred to as the new guidelines) jointly formulated by the National Cardiovascular Center and the Chinese Medical Association lowered the diagnostic criteria for hypertension in China to 130/80mmHg. Once implemented, the number of hypertensive patients in China will double to nearly 500 million. When the news came out, it quickly triggered heated discussion and controversy.
The day after the news was released, the share prices of many hypertensive pharmaceutical companies such as Huahai Pharmaceutical, Renfu Pharmaceutical and Rundu Co., Ltd. rose sharply.
Before the release of the new guidelines, the diagnostic criteria of hypertension in China were based on the 20 18 edition of the Guidelines for the Prevention and Treatment of Hypertension in China formulated by the China Hypertension Alliance. Sun Ningling, former chief physician of hypertension department of Peking University People's Hospital, told China Newsweek that the latest edition of "Guidelines for Prevention and Treatment of Hypertension in China" jointly formulated by China Hypertension Union and several societies will be published in late February this year. On the basis of 20 18, this guideline has been adjusted according to emerging research evidence, clinical needs and China's current economic situation. "This guide will continue to use 140/90mmHg as the diagnostic standard of hypertension." She said.
The downward adjustment of diagnostic criteria has caused many controversies.
Hypertension refers to the phenomenon that the pressure on the blood vessel wall is continuously higher than the normal value when human blood flows in the blood vessel. Because the early stage may be silent, it is called silent killer. Long-term hypertension will have a serious impact on important organs of human body, such as heart, brain and kidney.
The new Guidelines published on June 38+03, 2003 took two years to complete, and gave detailed evidence-based suggestions on 44 clinical problems related to diagnosis, evaluation and treatment in the field of hypertension, including lowering the diagnostic criteria of adult hypertension in China.
Before the release of the new guidelines, the diagnostic standard of hypertension in China was "Guidelines for the Prevention and Treatment of Hypertension in China". China Hypertension Union has been involved in the formulation and release of the first guideline since 1999, and it is updated every five years, with the latest update on 20 18. In the updated version of 20 18, hypertension is divided into three categories: 1, 2 and 3. When the blood pressure is 80 ~ 89 mmHg/130 ~139 mmHg, it is not judged as hypertension, and it belongs to normal high value. This is similar to the standard that has been used around the world for more than 20 years.
According to the data of China Cardiovascular Health and Disease Report 202 1 released in June this year, the number of patients with cardiovascular diseases in China is 330 million, including 245 million patients with hypertension. 245 million is calculated according to the diagnostic criteria of 140/90mmHg currently adopted in China. The new guideline reduces this standard to 130/80mmHg, which means that the number of hypertensive patients in China has increased from 245 million to 490 million.
Cai Jun, the founder and chief expert of the new guidelines and a professor at the National Cardiovascular Center/Fuwai Hospital of China Academy of Medical Sciences, pointed out in an interview with Caixin that "there are a lot of evidence-based medical evidences such as cohort studies and follow-up observation studies, which prove that elevated blood pressure is an important risk factor for cardiovascular death. Controlling blood pressure at a low level can bring obvious cardiovascular benefits. "
Cai Jun introduced that after adjusting the diagnostic criteria and antihypertensive targets, people with blood pressure above 1.40/90 mmHg will continue to receive medication, while patients with blood pressure between1.30 ~1.39mmhg/80 ~ 89mmhg are advised to carry out cardiovascular risk stratification, and only high-risk people will receive intensive antihypertensive treatment. Some high-risk groups should be treated with antihypertensive drugs, while others can.
Many hypertension experts are opposed to this revision. "There is no high-quality evidence that the blood pressure is in the range of130 ~139 mmHg/80 ~ 89 mmHg, and drug treatment will achieve obvious benefits." A number of hypertension experts told China Newsweek that they agreed to maintain the original standard and do not advocate lowering the range of hypertension now.
After the release of the new guidelines, the China Hypertension Alliance held a meeting to discuss this matter. "The' new director' was suddenly released without communicating with the alliance in advance." Liu, honorary chairman of China Hypertension Alliance and professor of Fuwai Hospital of China Academy of Medical Sciences, told China that other disease standards can be adjusted, because that is an academic issue, and hypertension is not. China Hypertension Alliance is a member organization of the World Hypertension Alliance (WHL). Liu has more than 50 years of experience in the prevention and treatment of hypertension. Prior to this, he participated in the formulation of every hypertension prevention guide in China.
"The degradation standard lacks high-quality evidence-based medical evidence." Liu said that hypertension is currently the only cardiovascular chronic disease prevention and treatment project listed in the national management. The formulation of standards is not only an academic dispute, but also closely related to people's livelihood. Easy adjustment will have a subversive impact. "According to this standard, the scope is too wide. People who used to engage in high-risk occupations such as pilots were suddenly diagnosed with hypertension. Can they continue to work in their original jobs? If something goes wrong, who is responsible? " She raised her own questions.
"When I first saw this lowered standard, I was shocked." Hu Dayi, chief physician of Cardiovascular Department of People's Hospital of University of Newsweek, told China that according to this standard, the number of hypertensive patients in China increased to 500 million overnight, including many young people.
"The diagnostic criteria of hypertension should not be changed easily." Hu Dayi told China Newsweek that lowering the diagnostic criteria did not reduce the absolute risk of controlling hypertension. At the same time, it also involves many problems, such as the side effects of drugs, huge medical expenses and labor costs. This down-regulation does not have much clinical significance.
"This new Guide has not yet reached an important standard with the China Hypertension Alliance." Sun Ningling said that the guideline should not only be in line with international standards, but also take into account the actual economic situation in China and the current incidence of hypertension.
On May 2nd this year, a randomized controlled clinical study report led by Liu He, President of the World Hypertension Union, lasted 14 years and 10624 people was released. Studies have shown that taking antihypertensive drugs can not only reduce the risk of cardiovascular and cerebrovascular diseases, but also bring harmful trends among the non-high-risk population aged 45-79 with blood pressure130-139/85-89 mmhg in China. At the same time, the study also suggested that controlling blood pressure through a healthy lifestyle may be the best choice for individuals with normal hypertension.
Hu Dayi said that people with high blood pressure 130 ~ 140 mmHg are not recommended to go to the hospital for prescription. It is more important to change their lifestyles, such as healthy eating, not staying up late and abstaining from alcohol.
Guo, an expert in formulating new guidelines and vice president of Hebei Provincial People's Hospital, said in an interview that lowering the diagnostic criteria of hypertension and letting more people pay attention to blood pressure at an earlier stage can significantly reduce the occurrence of cardiovascular and cerebrovascular complications. In this way, after 5 ~ 10 years, the reduction of cardiovascular and cerebrovascular diseases can save a lot of medical expenses, and the economic cost paid by a few people will be far less than these medical expenses.
Lowering diagnostic criteria will squeeze existing medical resources.
In 20 17, the American Heart Association (AHA) and the American Heart Association (ACC) jointly issued a new version of the guidelines for prevention and treatment of hypertension, which lowered the standard of hypertension from 140/90mmHg to 130/80mmHg.
However, developed countries failed to catch up in the following years, and WHO, International Society of Hypertension, European Society of Cardiology and Hypertension and World Hypertension Union did not change the standard of 140/90mmHg.
In fact, there is no general understanding of the diagnostic criteria of hypertension in the United States. 20 17- 12, the American Academy of Family Physicians (AAFP) issued a statement saying that the downward adjustment of diagnostic criteria is not recognized, and the definition of hypertension still follows the traditional standards. AAFP believes that although systematic review shows that the new standard can reduce cardiovascular events, there is no absolute authoritative evidence that it can reduce the impact of all-cause mortality, cardiovascular mortality and myocardial infarction on the whole population, and some existing research results are also contradictory.
Sun Ningling told China Newsweek that the awareness rate of hypertension in the United States is already very high, the treatment rate can reach 70%, and the disease control rate can reach 50% ~ 60%. Even if the diagnostic criteria are lowered, it can basically cover new patients. Comparatively speaking, according to the existing standards, the control rate of hypertension in China is only 15.3%, less than 6% in rural areas, and there are many hypertensive patients who need treatment. After the downward adjustment, the domestic hypertension control rate will drop to 3%, and the treatment of antihypertensive drugs will cause a run on existing medical resources.
"The National Health and Family Planning Commission does not support the new guidelines this time, and it should be considered from these levels." Sun Ningling said, "The treatment and control rate of hypertension in the United States is much higher than that in other countries in the world, and the goal of lowering blood pressure is tolerable. However, China's medical resources are limited. To reduce the diagnostic criteria, we must also consider whether the pressure of chronic disease prevention and control in the community, the ability to pay for medical insurance and the total medical and health expenditure can be borne for a long time. " Many grass-roots areas will assess the control rate of blood pressure reduction, and lowering the diagnostic criteria will greatly occupy the existing medical resources. "Hu Dayi said.
A senior medical person who asked not to be named gave an example to China Newsweek. There are over 300 community health service centers in Beijing. On average, a health service center covers about 654.38 million people, and each community health service center has more than a dozen teams of family doctors. There may be 50,000 to 60,000 patients under management, about half of whom are hypertensive patients, and most of the chronic patients in the community are elderly people suffering from multiple diseases at the same time. "According to this situation, even according to the 20 18 version of the guide, it is difficult to achieve effective management of hypertensive people." He said.
Even the American guideline of 20 17 only suggests lifestyle intervention for the non-high-risk population of130 ~139/80 ~ 89 mmhg, and not all of them need medication. In Hu Dayi's view, the downward adjustment of diagnostic criteria in the United States is more about advising patients to change their lifestyles. In the daily treatment of hypertension, it should vary from person to person, and we should not just look at millimeter mercury.
Many guidelines for diagnosis and treatment of cardiology and cardiac surgery are introduced by enterprises.
"The voice of the National Health Planning Commission is still timely." Hu Dayi said that if the standards are really lowered, the biggest winners will be the pharmaceutical companies behind them and some experts who get along with them. Even if they say there is no benefit, it is hard to stand the test. When making major decisions such as the Guide, especially when it comes to revising important standards, a third party must participate in the evaluation. This third party does not involve the interests of enterprises, nor should it involve the interests of doctors.
Hypertension, like diabetes, is two chronic diseases with a large population base in China. In China, once diagnosed, it is basically necessary to take medicine all the year round, and most of the diseases are irreversible.
The aforementioned senior medical personnel who did not want to be named told China Newsweek that at present, the general guidelines for hypertension treatment in China are basically issued by the industry. "Many guidelines for cardiology and cardiac surgery are basically launched by enterprises. In recent years, the grading policy of medical reform has been implemented in order to cut off the interests of enterprises, doctors and medical institutions. But it is still difficult to avoid the' rebate' link. "
According to the data of Sullivan Institute, under the diagnostic criteria of 140/90mmHg, the market scale of antihypertensive drugs has increased from 45.7 billion yuan in 20 13 to 88.5 billion yuan in 20 19, and the market scale is still increasing.
China's Newsweek noted that the stock prices of many antihypertensive drug manufacturers and sphygmomanometer manufacturers rose sharply due to the stimulus of the downward adjustment of diagnostic criteria. 165438+ 10/4, Jingxin Pharmaceutical, Huahai Pharmaceutical and Xinlitai with antihypertensive drugs increased by 8.26%, 6.09% and 5.57% respectively; In terms of the concept of sphygmomanometer, the daily limit of Yuyue Medical, Foucault Medical and Lexin Medical also increased by 14.00% and 8.48% respectively.
"It is pharmaceutical companies that really actively promote some standards." Hu Dayi said.
"I didn't expect a change in standards to bring a large influx of capital and stock market volatility." On June 5438+05, Sun Ningling posted on her personal social account, pointing out that from a medical point of view, the concept of disease prevention is very correct, and she also has many opinions in the new guide, but scholars can't just live in their own space.
The launch of this new Guide has caused a lot of discussion in the industry. In the opinion of many experts, its positive side is that it has aroused the attention of the industry and the public to the "invisible killer" hypertension. However, the industry has not yet reached a unified understanding of whether it is appropriate to reduce the current standard value of hypertension.
"I agree with some views on treatment in the new guidelines, but I have taken too big a step in the diagnostic criteria." Sun Ningling said that such a "guide" will cover many fields such as national medical care, economy, finance, insurance and public health construction. And it needs comprehensive consideration to stand up.
Reporter: Niu He