Ashida T, Yokoyama S, Ebihara A, Sugiyama T, Fujii J
Division of Cardiovascular Diseases, Institute for Adult Diseases Asahi Life Foundation, Tokyo, Japan.
Hypertens Res. 2001 May;24(3):203-7. doi: 10.1291/hypres.24.203.
The present study profiled patients who control doses of antihypertensive drugs by themselves based on self-monitoring of their blood pressure (self-controllers). A total of 1,028 consecutive outpatients who were taking antihypertensive drugs and who were attending the cardiovascular outpatient clinic of our institute responded to a questionnaire in 1998. They were asked how often they measured their blood pressure, how often they missed taking their medication, and whether or not they had a chance to adjust the doses of antihypertensive drugs by themselves based on self-monitored blood pressure. The frequency of self-controlling of antihypertensive drugs was also examined in 918 patients on antihypertensive drugs in 1997. In 1997, 23 of 918 patients (2.5%) were self-controllers, and 26 of 1,028 patients (2.5%) were self-controllers in 1998. The frequency of home blood-pressure measurement was significantly greater in self-controllers than in the remaining patients (non self-controllers) (p<0.01). The prevalence of proteinuria was significantly less in the former than in the latter. Prior to the start of antihypertensive drugs, blood pressure was significantly lower for the self-controllers (154.4+/-3.8/96.4+/-1.4 mmHg) than for the non self-controllers (169.3+/-0.7/101.7+/-0.4 mmHg) (p<0.001). Clinically measured blood pressures did not differ significantly between the self-controllers and non self-controllers. Thus, about 2.5% of patients on antihypertensive drugs controlled their drug doses by themselves based on self-monitoring of their blood pressure. These patients were characterized by having a milder form of hypertension and by more frequent home blood-pressure measurement than non self-controllers.
本研究对基于自我血压监测自行控制降压药物剂量的患者（自我控制者）进行了分析。1998年，共有1028名连续服用降压药物且在我院心血管门诊就诊的门诊患者对一份问卷做出了回应。问卷询问了他们测量血压的频率、漏服药物的频率，以及是否有机会根据自我监测的血压自行调整降压药物剂量。1997年，对918名服用降压药物的患者的降压药物自我控制频率也进行了调查。1997年，918名患者中有23名（2.5%）为自我控制者，1998年，1028名患者中有26名（2.5%）为自我控制者。自我控制者的家庭血压测量频率显著高于其余患者（非自我控制者）（p<0.01）。前者的蛋白尿患病率显著低于后者。在开始服用降压药物之前，自我控制者的血压（154.4±3.8/96.4±1.4 mmHg）显著低于非自我控制者（169.3±0.7/101.7±0.4 mmHg）（p<0.001）。自我控制者和非自我控制者临床测量的血压没有显著差异。因此，约2.5%的服用降压药物的患者根据自我血压监测自行控制药物剂量。这些患者的特点是高血压病情较轻，且家庭血压测量比非自我控制者更频繁。
