Leibovitz Eyal, Gavish Dov, Dicker Dror, Viskoper Reuven J, Yosefi Chaim
Department of Internal Medicine A, Wolfson Medical Center, Holon, Israel.
Isr Med Assoc J. 2003 Oct;5(10):697-701.
The Israeli Blood Pressure Control program was initiated to enhance the control of modifiable risk factors among high risk hypertensive patients followed by general practitioners in Israel.
To report the baseline results of the state of the treatment regarding blood pressure management, lipid and glucose control as well as obesity and smoking cessation among the patients.
Hypertensive patients were screened in 30 general practice clinics supervised by family medicine specialists seeing 1,000-5,000 patients each. Between 50 and 250 hypertensive patints were diagnosed at each participating clinic. Blood pressure levels, body mass index, lipid and glucose levels, as well as target organ damage and medications were recorded for all patients.
Of the 4,948 patients registered, 2,079 were males (42%). Mean age was 64.8 +/- 12. Blood pressure control was achieved in only 33.1% of total hypertensive patients. Low density lipoprotein control was achieved in 31.1% of all patients, and glucose control in only 28.5%% of diabetic patients (glucose < 126 mg/dl); 20.7% of the diabetics had glucose levels above 200 mg/dl. In this group of patients 38.9% were obese (BMI > 30 kg/m2). While there were more obese females than males (48.0% vs. 35.6%), no difference was found in blood pressure, lipid or glucose control between the genders.
Risk factor management of hypertensive patients attending general practice clinics in Israel is not optimal, especially among those with diabetes or in need of secondary prevention measures. A long-term intervention program for high risk patients in the community is needed to improve the current situation.
以色列启动了血压控制项目,以加强以色列全科医生所诊治的高危高血压患者中可改变危险因素的控制。
报告患者在血压管理、血脂和血糖控制以及肥胖与戒烟方面的治疗基线结果。
在30家由家庭医学专家监督的全科诊所对高血压患者进行筛查,每家诊所诊治1000 - 5000名患者。每家参与诊所诊断出50至250名高血压患者。记录所有患者的血压水平、体重指数、血脂和血糖水平以及靶器官损害和用药情况。
在登记的4948名患者中,2079名是男性(42%)。平均年龄为64.8±12岁。仅33.1%的高血压患者实现了血压控制。31.1%的患者实现了低密度脂蛋白控制,仅28.5%的糖尿病患者实现了血糖控制(血糖<126mg/dl);20.7%的糖尿病患者血糖水平高于200mg/dl。在这组患者中,38.9%为肥胖(体重指数>30kg/m²)。虽然肥胖女性多于男性(48.0%对35.6%),但两性在血压、血脂或血糖控制方面未发现差异。
以色列全科诊所高血压患者的危险因素管理并不理想,尤其是在糖尿病患者或需要二级预防措施的患者中。需要针对社区高危患者开展长期干预项目以改善当前状况。