“Not to do” messages from the 2022 TSOC/THS Hypertension Guidelines
2022 TSOC/THS 高血壓指引中建議不要做的事項
1.Routine office BP should not be used for the diagnosis and management of hypertension unless the recommended BP measurement protocol is followed.
除非遵循推薦的血壓測量方案，否則不應將常規診間血壓測量(Routine office BP)用於高血壓的診斷和管理。
2.People without a habit of alcohol consumption should not start drinking for any reason.
沒有飲酒習慣的人不應該以任何理由開始飲酒。
3.Binge drinking (defined as ≥ 5 and ≥4 drinks for men and women, respectively, in 2 hours) should be strictly prohibited to reduce BP, as well as the risk of atrial fibrillation, stroke and sudden death.
為了降低血壓，與同時降低心房顫動、中風和猝死的風險。應禁止過度飲酒(定義為男性和女性在 2 小時內分別 ≥ 5 和 ≥ 4 杯註1)。
4.High-intensity exercise is not recommended for patients with uncontrolled hypertension (SBP > 160 mmHg).
高血壓未獲控制的病人（SBP > 160 mmHg）不建議進行高強度運動(High-intensity exercise) 註2。
5.Any combination of direct renin inhibitor, ACE inhibitors and ARBs is contraindicated.
禁止並用直接腎素抑製劑、ACE 抑製劑和 ARB 的任何組合。
6.It is not recommended to lower BP in the prehospital setting without knowing the phenotypes of stroke.
若不清楚病人的中風類型，不建議到院治療前為中風病人進行降壓之處置
7.Routine aggressive BP lowering is not recommended unless BP≥ 220/120 or in the presence of other situations needing immediate BP lowering (such as acute aortic dissection, congestive heart failure with lung edema, hypertensive encephalopathy)
within 24 hours of acute ischemic stroke without undergoing thrombolytic or endovascular therapy.
在未接受溶栓或血管內治療的急性缺血性中風24小時內，不建議常規積極降壓，除非 BP ≥ 220/120 或存在其他需要立即降壓的情況（如主動脈剝離、充血性心衰竭伴肺水腫、高血壓腦病）
8.Salt reduction (less than 6 g/day) is not recommended as a non-drug therapy for gestational hypertension.
不建議將限鹽（少於 6 g/天）作為妊娠高血壓的非藥物療法。
9.ACE inhibitors, ARBs, DRI, ARNI, mineralocorticoid receptor antagonists, and chlorothiazide are teratogenic. Women with hypertension who become pregnant, are planning to become pregnant, or with child-bearing potential without reliable contraception, should avoid, or immediately withdraw these drugs in case of pregnancy.
由於ACE inhibitors, ARBs, DRI, ARNI, mineralocorticoid receptor antagonists, and chlorothiazide具有致畸作用。因此應避免在懷孕、計劃懷孕或有生育能力但沒有可靠避孕措施的高血壓婦女使用，若有使用應於懷孕時立即停用這些藥物。
10.Oral contraceptives should not be used in women with uncontrolled hypertension.
高血壓未獲控制的女性不應使用口服避孕藥。
11.Hormone replacement therapy, as well as selective estrogen receptor modulators, should not be used for the primary or secondary prevention of CV diseases in postmenopausal women.
賀爾蒙替代療法以及選擇性雌激素受體調節劑不應用於停經後婦女心血管疾病的一級或二級預防。
註1
1杯(drink)= 14 克純酒精
註2:
費力身體運動 (High-intensity Exercise)：持續從事10分鐘以上時，無法邊活動，邊跟人輕鬆說話。這類活動會讓身體感覺很累，呼吸和心跳比平常快很多，也會流很多汗。
中度身體運動 (Moderate-intensity Exercise)：持續從事10分鐘以上還能順暢地對話，但無法唱歌。這類活動會讓人覺得有點累，呼吸及心跳比平常快一些，也會流一些汗。
輕度身體運動 (Low-intensity Exercise)：不太費力的輕度身體活動。
坐式生活型態 (Sedentary)：僅止於靜態生活的內容。
Ref
1. 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension – A Report of the Task Force of the Hypertension Committee and the Guideline Committee of the Taiwan Society of Cardiology and the Taiwan Hypertension Society (2022)
2.運動強度 https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=571&pid=9739
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