Volpe Massimo, Tocci Giuliano, Trimarco Bruno, Rosei Enrico Agabiti, Borghi Claudio, Ambrosioni Ettore, Menotti Alessandro, Zanchetti Alberto, Mancia Giuseppe
Division of Cardiology, II Faculty of Medicine, University of Rome La Sapienza, Sant'Andrea Hospital, Rome, Italy.
J Hypertens. 2007 Jul;25(7):1491-8. doi: 10.1097/HJH.0b013e3280fa83a6.
Blood pressure (BP) control is reported to be poor in hypertensive patients worldwide.
BP levels, the rate of BP control, prevalence of risk factors and total cardiovascular risk were assessed in a large cohort of hypertensive patients, derived from recent surveys performed in Italy.
Fifteen studies on hypertension, performed in different clinical settings (general population, general clinical practice, specialist outpatient clinics and hypertension centres) over the past decade were considered.
The overall sample included 52 715 hypertensive patients (26 315 men and 26 410 women, mean age 57.3 +/- 6.9 years). Despite the high percentage of patients on stable antihypertensive treatment (n = 36 556, 69%), mean systolic and diastolic BP levels were 147.8 +/- 8.5 and 89.5 +/- 5.2 mmHg, respectively. On the basis of the nature of the study (population surveys or clinical referrals), systolic BP levels were consistently higher than the normality threshold in both settings (142.6 +/- 12.4/84.8 +/- 3.7 mmHg and 150.4 +/- 4.6/91.9 +/- 4.1 mmHg, respectively). The BP stratification could be assessed in 40 829 individuals: 4.5% had optimal, 9.2% normal and 8.3% high-normal BP levels, however, the large majority were in grade 1 (39%) or grades 2-3 (32.6%) hypertension. In the overall sample, 55.9% of hypertensive patients had hypercholesterolemia, 28.7% were smokers, 36.4% were overweight or obese and 15.0% had diabetes mellitus. Cardiovascular risk stratification was assessed in 37 813 hypertensives: 23.2% had low, 33.9% moderate, 30.2% high and 12.7% very high added risk.
Our analysis demonstrates the persistence of poor BP control and high prevalence of risk factors, supporting the need for more effective, comprehensive and urgent actions to improve the clinical management of hypertension.
据报道，全球高血压患者的血压控制情况较差。
在源自意大利近期调查的一大群高血压患者中，评估血压水平、血压控制率、危险因素患病率及总体心血管风险。
纳入了过去十年间在不同临床环境（普通人群、普通临床实践、专科门诊及高血压中心）开展的15项高血压研究。
总体样本包括52715例高血压患者（男性26315例，女性26410例，平均年龄57.3±6.9岁）。尽管接受稳定降压治疗的患者比例较高（n = 36556，69%），但平均收缩压和舒张压水平分别为147.8±8.5 mmHg和89.5±5.2 mmHg。根据研究性质（人群调查或临床转诊），两种情况下收缩压水平均持续高于正常阈值（分别为142.6±12.4/84.8±3.7 mmHg和150.4±4.6/91.9±4.1 mmHg）。可对40829例个体进行血压分层：4.5%血压最优，9.2%正常，8.3%血压正常高值，然而，绝大多数处于1级（39%）或2 - 3级（32.6%）高血压。在总体样本中，55.9%的高血压患者患有高胆固醇血症，28.7%为吸烟者，36.4%超重或肥胖，15.0%患有糖尿病。对37813例高血压患者进行了心血管风险分层：23.2%风险较低，33.9%为中度，30.2%为高度，12.7%为极高额外风险。
我们的分析表明血压控制不佳和危险因素高患病率持续存在，支持需要采取更有效、全面且紧急的行动来改善高血压的临床管理。
