Llisterri Caro José L, Rodríguez Roca Gustavo C, Alonso Moreno Francisco J, Lou Arnal Salvador, Divisón Garrote Juan A, Santos Rodríguez José A, Raber Béjar Anna, de Castellar Sansó Rous, Ruilope Urioste Luis M, Banegas Banegas José R
Centro de Salud de Alaquas. Valencia. España.
Med Clin (Barc). 2004 Feb 14;122(5):165-71. doi: 10.1016/s0025-7753(04)74183-4.
More information is needed on hypertension control in clinical practice, which includes taking at least two blood pressure (BP) readings and taking into account surgery times and previous antihypertensive drug intake. Our study aimed to assess the optimum degree of BP control in a broad sample of Spanish hypertensive patients in primary care and to determine factors associated with a poor control.
Cross-sectional, multicenter study of hypertensive patients aged over 18 years and treated with drugs during the preceeding three months, who were recruited by general practitioners through consecutive sampling in primary care settings throughout Spain over 3 consecutive days. BP measurements were performed in surgery hours (morning and evening) following standardized methods and averaging two consecutive readings. An average BP lower than 140/90 mm Hg (values lower than 130/85 mm Hg in diabetics) was regarded as optimum BP control.
12 754 patients were included, mean age 63.3 years (10.8), 57.2% women. 36.1% (95% CI, 35.2-36.9) had good systolic blood pressure (SBP) and diastolic blood pressure (DBP) controls, 39.1% (95% CI, 38.3-40.0) had good SBP control only, and 73.1% (95% CI, 72.3-73.9) had good DBP control only. BP control was significantly (*2, p < 0.001) better during evening than during morning measurements (43.6% vs 37.1%) and in patients who had taken antihypertensive treatment before measurement (37.2%) vs. those who had not taken it (21.0%). Factors such as alcohol consumption, sedentary lifestyle, obesity and age were all associated with poor BP control (Wald's (chi 2, p < 0.001).
The results of the PRESCAP 2002 study indicate that approximately 4 out of 10 hypertensive patients treated pharmacologically by primary health care centers in Spain have optimal BP control. Significant differences were found in the degree of control depending on surgery hours and the previous intake of antihypertensive medication.
临床实践中高血压控制方面需要更多信息，这包括至少测量两次血压读数，并考虑测量时间及之前的降压药物服用情况。我们的研究旨在评估西班牙基层医疗中广大高血压患者样本的最佳血压控制程度，并确定与控制不佳相关的因素。
对年龄在18岁以上且在之前三个月内接受药物治疗的高血压患者进行横断面、多中心研究，由全科医生在西班牙各地基层医疗机构通过连续抽样，连续三天招募患者。在测量时间（上午和晚上）按照标准化方法测量血压，并对连续两次读数取平均值。平均血压低于140/90 mmHg（糖尿病患者低于130/85 mmHg）被视为最佳血压控制。
共纳入12754例患者，平均年龄63.3岁（10.8岁），女性占57.2%。36.1%（95%可信区间，35.2 - 36.9）患者的收缩压（SBP）和舒张压（DBP）控制良好，39.1%（95%可信区间，38.3 - 40.0）患者仅SBP控制良好，73.1%（95%可信区间，72.3 - 73.9）患者仅DBP控制良好。晚上测量时的血压控制显著（*2，p < 0.001）优于上午测量时（43.6%对37.1%），且测量前服用过降压治疗的患者（37.2%）的血压控制优于未服用过的患者（21.0%）。饮酒、久坐不动的生活方式、肥胖和年龄等因素均与血压控制不佳相关（Wald检验（卡方检验，p < 0.001））。
PRESCAP 2002研究结果表明，西班牙基层医疗中心接受药物治疗的高血压患者中，约十分之四的患者血压控制最佳。根据测量时间和之前降压药物的服用情况，血压控制程度存在显著差异。
