Obara Taku, Ohkubo Takayoshi, Kikuya Masahiro, Asayama Kei, Metoki Hirohito, Inoue Ryusuke, Oikawa Takuya, Murai Kayo, Komai Rie, Horikawa Tsuyoshi, Hashimoto Junichiro, Totsune Kazuhito, Imai Yutaka
Department of Clinical Pharmacology, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, Sendai, Japan.
Diabetes Res Clin Pract. 2006 Sep;73(3):276-83. doi: 10.1016/j.diabres.2006.01.015. Epub 2006 Apr 3.
Although self-measured blood pressure (BP) at home (HBP) has become popular in clinical practice, little information is available regarding the proportion of diabetic patients with properly controlled HBP. We evaluated the status of HBP control in diabetic hypertensives. HBP control status was cross-sectionally evaluated among 3400 essential hypertensives taking antihypertensive treatment. Of these, 466 (14%) had diabetes. Physicians evaluated the subjects' HBP control as "poor", "fairly good", or "excellent" using a self-administered questionnaire. When the HBP threshold in diabetic patients was set tentatively at 130/80 mmHg or 135/85 mmHg, HBP was properly controlled in 18% or 30% of diabetic patients, respectively. The same trend was observed in office BP. The average number of drugs prescribed for diabetic patients was 2.0 drugs. In the majority of diabetic patients with uncontrolled BP, the BP control status in two-thirds of those was evaluated as "excellent" or "fairly good" by their physicians. In Japan, HBP and office BP were not adequately controlled in most diabetic hypertensives. The main reason for this would appear to be a lack of intensive treatment and a lack of recognition by physicians that their patients' BP was insufficiently controlled.
尽管家庭自测血压（HBP）在临床实践中已很普遍，但关于血压得到合理控制的糖尿病患者比例的信息却很少。我们评估了糖尿病高血压患者的家庭血压控制状况。对3400名正在接受降压治疗的原发性高血压患者的家庭血压控制状况进行了横断面评估。其中，466人（14%）患有糖尿病。医生通过一份自填式问卷将受试者的家庭血压控制状况评估为“差”、“尚可”或“良好”。当将糖尿病患者的家庭血压阈值暂定设定为130/80 mmHg或135/85 mmHg时，家庭血压分别在18%或30%的糖尿病患者中得到了合理控制。诊室血压也观察到了相同的趋势。糖尿病患者的平均用药数量为2.0种。在大多数家庭血压未得到控制的糖尿病患者中，其中三分之二患者的血压控制状况被医生评估为“良好”或“尚可”。在日本，大多数糖尿病高血压患者的家庭血压和诊室血压都未得到充分控制。出现这种情况的主要原因似乎是缺乏强化治疗以及医生未认识到其患者的血压控制不充分。
