Pechère-Bertschi Antoinette, Greminger Peter, Hess Lorenzo, Philippe Jacques, Ferrari Paolo
Division of Endocrinology and Medical Policlinic, University Hospital, Geneva, Switzerland.
Blood Press. 2005;14(6):337-44. doi: 10.1080/08037050500340018.
The prevalence of hypertension in type 2 diabetics is high, though there is no published data for Switzerland. This prospective cohort survey determined the frequency of type 2 diabetes mellitus associated with hypertension from medical practitioners in Switzerland, and collected data on the diagnostic and therapeutic work-up for cardiovascular risk patients. The Swiss Hypertension And Risk Factor Program (SHARP) is a two-part survey: The first part, I-SHARP, was a survey among 1040 Swiss physicians to assess what are the target blood pressure (BP) values and preferred treatment for their patients. The second part, SHARP, collected data from 20,956 patients treated on any of 5 consecutive days from 188 participating physicians. In I-SHARP, target BP?135/85 mmHg, as recommended by the Swiss Society of Hypertension, was the goal for 25% of physicians for hypertensives, and for 60% for hypertensive diabetics; values >140/90 mmHg were targeted by 19% for hypertensives, respectively 9% for hypertensive diabetics. In SHARP, 30% of the 20,956 patients enrolled were hypertensive (as defined by the doctors) and 10% were diabetic (67% of whom were also hypertensive). Six per cent of known hypertensive patients and 4% of known hypertensive diabetics did not receive any antihypertensive treatment. Diabetes was not treated pharmacologically in 20% of diabetics. Proteinuria was not screened for in 45% of known hypertensives and in 29% of known hypertensive diabetics. In Switzerland, most physicians set target BP levels higher than recommended in published guidelines. In this country with easy access to medical care, high medical density and few financial constraints, appropriate detection and treatment for cardiovascular risk factors remain highly problematic.
2型糖尿病患者中高血压的患病率很高，不过瑞士尚无相关公开数据。这项前瞻性队列调查确定了瑞士医生诊断的2型糖尿病合并高血压的发生率，并收集了心血管风险患者的诊断和治疗检查数据。瑞士高血压与风险因素项目（SHARP）分为两部分调查：第一部分，I-SHARP，是对1040名瑞士医生进行的一项调查，以评估他们为患者设定的目标血压（BP）值和首选治疗方法。第二部分，SHARP，收集了来自188名参与医生连续5天内治疗的20956名患者的数据。在I-SHARP中，按照瑞士高血压学会的建议，目标血压≤135/85 mmHg，是25%的医生针对高血压患者设定的目标，而针对高血压糖尿病患者的这一比例为60%；19%的医生针对高血压患者设定的目标值>140/90 mmHg，针对高血压糖尿病患者的这一比例为9%。在SHARP中，纳入的20956名患者中有30%为高血压患者（由医生定义），10%为糖尿病患者（其中67%同时患有高血压）。6%的已知高血压患者和4%的已知高血压糖尿病患者未接受任何降压治疗。20%的糖尿病患者未接受药物治疗。45%的已知高血压患者和29%的已知高血压糖尿病患者未进行蛋白尿筛查。在瑞士，大多数医生设定的目标血压水平高于已发表指南中的建议。在这个就医便利、医疗密度高且经济限制少的国家，心血管危险因素的适当检测和治疗仍然存在很大问题。
