在教学医院环境中观察到的导致顽固性高血压的因素。

Observed factors responsible for resistant hypertension in a teaching hospital setting.

作者信息

Salako B L, Ayodele O E

机构信息

Department of Medicine, College of Medicine, University of Ibaban, University College Hospital, Ibadan, Nigeria.

出版信息

Afr J Med Med Sci. 2003 Jun;32(2):151-4.

PMID:15032461

Abstract

Assessment of control of hypertension by some authors has revealed that optimal blood pressure control is not yet achieved in many of those that are on treatment. Resistant hypertension, plays a part as one of the factors responsible for this poor control state. Because of the peculiar problems posed by this group of hypertensives, we assessed the burden and factors responsible for resistant hypertension among hypertensive subjects attending the Medical Outpatient Clinic of the University College Hospital, Ibadan, Nigeria. Resistant hypertension was defined as blood pressure [symbol: see text] 140/90 mmHg in the presence of use of a combination of three antihypertensive drugs, including a diuretic at near maximum doses for at least one month. Five hundred and sixty-six consecutive subjects (218 males and 348 females) with a mean age of 56.0 +/- 14.3 years were screened for resistant hypertension. One hundred and forty-four (mean age 54.55 +/- 15.1 years), were fully controlled with a blood pressure of 120 +/- 9/77 +/- 2 mmHg. 394 men age of 56.7 +/- 11.7 years had non-resistant hypertension with blood pressure of 167.5 +/- 23/102.3 +/- 1.2 mmHg. Only 28 (5%) of the whole study group (mean age 51.8 +/- 9.7 years) were found to have resistant hypertension with a blood pressure of 176.4 +/- 43/109.6 +/- 14.8 mmHg. The subjects with resistant hypertension were significantly younger than those with non-resistant hypertension P < 0.02. There was no significant difference between their systolic blood pressure (P > 0.3) whereas; there was a significant difference between their diastolic blood pressure P < 0.002. Among those who had resistant hypertension, non-compliance was documented in 14 (50%) while it was in 73 (18.5%) of those without resistant hypertension P < 0.00053. Alcohol, tobacco, Obesity, use of non-steroidal anti-inflammatory drugs and excessive use of salt were not found as key factors responsible for resistant hypertension in this study.

摘要

一些作者对高血压控制情况的评估显示，许多接受治疗的患者尚未实现最佳血压控制。顽固性高血压是导致这种控制不佳状态的因素之一。由于这类高血压患者存在特殊问题，我们对尼日利亚伊巴丹大学学院医院门诊就诊的高血压患者中顽固性高血压的负担及相关因素进行了评估。顽固性高血压的定义为在联合使用三种抗高血压药物（包括近最大剂量的利尿剂）至少一个月的情况下，血压仍≥140/90 mmHg。对566名连续的受试者（218名男性和348名女性）进行了顽固性高血压筛查，其平均年龄为56.0±14.3岁。144名（平均年龄54.55±15.1岁）血压控制良好，血压为120±9/77±2 mmHg。394名男性（平均年龄56.7±11.7岁）患有非顽固性高血压，血压为167.5±23/102.3±1.2 mmHg。在整个研究组中，只有28名（5%）（平均年龄51.8±9.7岁）被发现患有顽固性高血压，血压为176.4±43/109.6±14.8 mmHg。顽固性高血压患者明显比非顽固性高血压患者年轻，P<0.02。他们的收缩压之间无显著差异（P>0.3），然而，舒张压之间存在显著差异，P<0.002。在患有顽固性高血压的患者中，14名（50%）存在治疗依从性差的情况，而在无顽固性高血压的患者中，这一比例为73名（18.5%），P<0.00053。在本研究中，未发现酒精、烟草、肥胖、使用非甾体抗炎药和过量摄入盐是导致顽固性高血压的关键因素。