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高血压的药物治疗:基层医疗环境中一组高血压患者的依从性和不良反应

Drug treatment of hypertension: compliance and adverse reactions in a cohort of hypertensive patients in a primary care setting.

作者信息

Mino-León Dolores, Reyes-Morales Hortensia, Galván-Plata María Eugenia, Ponce-Monter Héctor, Palma-Aguirre José Antonio, Amato Dante, Figueras Albert

机构信息

Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social.

出版信息

Rev Invest Clin. 2007 Jan-Feb;59(1):8-14.

Abstract

OBJECTIVES

The primary was to assess the frequency of therapeutic non-compliance due to ADRs in a cohort of patients with recently diagnosed systemic hypertension. The secondary objectives were to evaluate the blood pressure control during the follow-up in the whole cohort and in patients who received non-steroidal anti-inflammatory drugs (NSAIDs).

METHODS

A cohort of 73 recently diagnosed ambulatory hypertensive patients was followed-up for 6 months. Validated questionnaires for identification of therapeutic scheme changes and ADRs were applied monthly, during each medical visit.

RESULTS

Family physicians selected monotherapy in 79% of patients. The frequency of therapeutic non-compliance was 44%; non-compliance secondary to ADR was 7%. Systolic and diastolic blood pressure at the beginning of the study were 140 +/- 15/90 +/- 15 mm Hg for the whole cohort. At the end of the study the figures were 130 +/- 11/85 +/- 6 (p < 0.001). Patients receiving non-steroidal anti-inflammatory drugs (NSAIDs) had higher blood pressure levels than the groups of patients not receiving such kind of drugs (134 +/- 10 vs. 128 +/- 8 mm Hg, p = 0.025 and 88 +/- 7 vs. 83 +/- 5 mm Hg, p = 0.05).

CONCLUSIONS

The drugs used in the present study as monotherapy are considered acceptable choices for hypertension treatment. The frequency of therapeutic non-compliance was within the limits reported in the literature and the frequency of therapeutic non-compliance secondary to ADRs in this cohort was lower than that reported in the literature. Higher blood pressure was found in the group of patients receiving NSAIDs.

摘要

目的

主要目的是评估近期诊断为系统性高血压的一组患者中因药物不良反应导致治疗不依从的频率。次要目的是评估整个队列以及接受非甾体抗炎药(NSAIDs)治疗的患者在随访期间的血压控制情况。

方法

对73例近期诊断为门诊的非卧床高血压患者进行了为期6个月的随访。在每次就诊时,每月使用经过验证的问卷来确定治疗方案的变化和药物不良反应。

结果

家庭医生为79%的患者选择了单一疗法。治疗不依从的频率为44%;因药物不良反应导致不依从的频率为7%。整个队列在研究开始时的收缩压和舒张压分别为140±15/90±15 mmHg。研究结束时,数据为130±11/85±6(p<0.001)。接受非甾体抗炎药(NSAIDs)治疗的患者血压水平高于未接受此类药物治疗的患者组(134±10 vs. 128±8 mmHg,p = 0.025;88±7 vs. 83±5 mmHg,p = 0.05)。

结论

本研究中作为单一疗法使用的药物被认为是高血压治疗的可接受选择。治疗不依从的频率在文献报道的范围内,并且该队列中因药物不良反应导致治疗不依从的频率低于文献报道。接受NSAIDs治疗的患者组血压较高。

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