Chamontin B, Lang T, Vaisse B, Nicodeme R, Antoine M P, Lazorthes M L, Gallois H, Poggi L
Service de médecine interne et HTA, CHU Purpan, Toulouse.
Arch Mal Coeur Vaiss. 2001 Aug;94(8):869-73.
To evaluate the characteristics of diabetic hypertensive patients (Pts), in term of associated cardiovascular risk factors and blood pressure control in a representative population issued from a survey "PHARE" conducted in general practice in France in 1999.
PHARE survey was conducted in a sample of 225 GPs representative of the French medical population included in a gallup poll. GPs had to include all patients > 18 years old over a period of one week. Pts were considered as hypertensives (HP) if the mean of two recorded BP measurements was = 140/90 mmHg and/or < 140/90 mmHg if they were under antihypertensive treatment. Patients were considered as diabetics if they were previously known and/or if they received a medication for diabetes. Hypertensives were considered as controlled if their BP levels were overall < 140/90 mmHg or at the recommended threshold < 130/85 mmHg under treatment.
877 diabetic Pts (7%) among 12.342 Pts and 5.190 HP were included in the study. When compared to normotensives, diabetic HP had more frequently associated risk factors with hypertension and diabetes: overweight 71% vs 45%, dyslipidemia 61% vs 34%, sendentarily 73% vs 63%, tobacco consumption 27% vs 20%. The BP control at 140/90 mmHg threshold among treated diabetic HP was 21%, and only 8% at 130/85 mmHg. Regarding WHO classification, 79% of these diabetics had a high or very high cardiovascular risk. The were no difference in antihypertensive drugs used in HP diabetics and non diabetics and 50% of them received ACEI.
8 from 10 diabetics taken in charge in general practice are hypertensives and 8 from 10 have a very high cardiovascular risk due to a poor BP control and associated cardiovascular risk factors.
在1999年法国普通科开展的一项“灯塔”（PHARE）调查所涵盖的具有代表性人群中，从相关心血管危险因素和血压控制方面评估糖尿病高血压患者的特征。
“灯塔”调查在225名代表法国医学人群的全科医生样本中进行，这些医生参与了一项盖洛普民意调查。全科医生必须纳入在一周时间内所有年龄大于18岁的患者。如果两次记录的血压测量平均值 = 140/90 mmHg，则患者被视为高血压患者（HP）；如果他们正在接受抗高血压治疗且血压 < 140/90 mmHg，也被视为高血压患者。如果患者既往已知患有糖尿病和/或正在接受糖尿病药物治疗，则被视为糖尿病患者。如果高血压患者的血压水平总体 < 140/90 mmHg 或在治疗时处于推荐阈值 < 130/85 mmHg，则被视为血压得到控制。
12342名患者中有877名糖尿病患者（7%）和5190名高血压患者被纳入研究。与血压正常者相比，糖尿病高血压患者更常伴有高血压和糖尿病相关的危险因素：超重分别为71% 对 45%，血脂异常分别为61% 对 34%，久坐分别为73% 对 63%，吸烟分别为27% 对 20%。在接受治疗的糖尿病高血压患者中，血压控制在140/90 mmHg阈值的比例为21%，在130/85 mmHg时仅为8%。根据世界卫生组织分类，这些糖尿病患者中有79%具有高或非常高的心血管风险。糖尿病高血压患者和非糖尿病高血压患者使用的抗高血压药物没有差异，其中50%接受了血管紧张素转换酶抑制剂（ACEI）。
在普通科诊治的糖尿病患者中，十分之八为高血压患者，并且由于血压控制不佳和相关心血管危险因素，十分之八具有非常高的心血管风险。
