摘要
目的了解中国冠心病患者血压控制及降压药物使用情况,分析影响血压控制的因素。方法借助国际多中心大规模临床试验HPS2-THRIVE在中国实施之际,在14座城市的51家医院中对冠心病患者进行调查。利用电子问卷,收集基本情况、病史、吸烟、饮酒和用药资料,测量血压及身高、体质量和腰围,计算达标率。结果 2007年6月至2009年10月期间共调查冠心病患者13 015例,年龄50～80岁,平均(63±8)岁。8033例患者(61.7%)已知明确的高血压病史,其中90.6%服用降压药物,仅30.1%血压控制达标。50～59岁、60～69岁和70～80岁年龄组达标率分别为35.8%、29.3%和25.0%。未服药组、服用1种药物组、服用2种药物组和服用3种及以上组的血压达标率分别为21.1%、26.8%、32.3%和34.9%。大量饮酒者、合并糖尿病或缺血性脑卒中的患者血压达标率(分别为23.8%、19.8%和24.4%)明显低于无此情况者(分别为29.8%、39.5%和32.2%)。相反,接受经皮冠状动脉介入治疗、冠状动脉旁路移植术和服用他汀类药物者血压达标率(分别为35.2%、32.0%和35.2%)均高于无此情况者(分别为25.1%、29.8%和23.2%)。无高血压病史的患者中,仅58.9%血压正常。结论中国冠心病患者血压控制情况距指南要求仍存在很大差距,在大量饮酒以及合并糖尿病或脑卒中的患者中更为突出。
Objective To investigate the blood pressure control and anti-hypertensive medication use in patientswith established coronary heart disease （CHD） and determine the influencing factors of blood pressure control. Methods Patients with CHD were interviewed for collecting their characteristics, life style, medication, blood pressure, body mass index and waist circumference. The patients were from potential participants screened for a multicenter clinical trial, which was carried out in 14 cities in China. Results From June 2007 to October 2009, 13 015 patients with CHD were interviewed. A history of hypertension was present in 8033 （61.7%） patients, 90.6% of whom were taking antihypertensive medicine, and only 30. 1% reached the goal of blood pressure control. Blood pressure control rate of 50 - 59 years, 60 -69 years and 70 -80 years groups were 35.8% , 29. 3% and 25.0%. And the proportion of reaching blood pressure goal was increased with the increase of the number of anti-hypertensive medicine. Blood pressure control rate was significantly lower in heavy drinkers （23.8% vs. 29. 8% ） , patients with comorbid diabetes （ 19.6% vs. 39. 5% ） or ischemic stroke （24. 4% vs. 32. 2% ） than those without these conditions mentioned above. On the contrary, patients with previous PCI （34. 9% vs. 25.1% ）, CABG （32. 0% vs. 29. 8% ） or patients taking statins （35.2% vs. 23.2% ） had significantly higher blood control rate than those without. Among patients without hypertension history, 41.1% showed elevated blood pressure when interviewed. Conclusions There is a large gap between blood pressure control status and the clinical guideline in patients with CHD, particularly in heavy drinkers and patients with comorbid diabetes or stroke.
出处
《中国心血管杂志》
2011年第3期161-165,共5页
Chinese Journal of Cardiovascular Medicine
