MacDonald T M, Morant S V, Mozaffari E
Medicines Monitoring Unit, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK.
J Hum Hypertens. 2007 Dec;21(12):925-33. doi: 10.1038/sj.jhh.1002249. Epub 2007 Jul 5.
Few studies have investigated the presence of dyslipidaemia in hypertensive individuals. In addition, few data exist on the concurrent treatment of both conditions for the prevention of cardiovascular disease (CVD). This retrospective cohort study examined treatment patterns for hypertension and dyslipidaemia among hypertensive patients in UK primary care. We defined a population of patients aged > or =40 years from the UK General Practice Research Database. Hypertensive individuals with > or =3 additional cardiovascular risk factors (ARFs) were compared with a cohort comprising hypertensive patients with < or =2 ARFs. We analysed the prevalence of risk factors and the prevalence and incidence of treatment for hypertension, dyslipidaemia and for both conditions between January 1997 and December 2001. A total of 117 840 hypertensive patients were identified (23 655 with > or =3 ARFs, 94 185 with < or =2 ARFs) in 1997; in 2001, the number diagnosed as hypertensive was 133 683 (40 248 > or =3 ARFs, 93 435 < or =2 ARFs). The prevalence of antihypertensive treatment in the hypertensive patients with > or =3 ARFs increased during the study. In 2001, approximately one-third of hypertensive patients with > or =3 ARFs were not receiving antihypertensives. Among those patients who received such treatment, the majority received > or =2 separate agents in accordance with current guidelines. Treatment for concurrent hypertension and dyslipidaemia was initiated in <8% of patients with hypertension and > or =3 ARFs in each year. These findings demonstrate the under-recognition/undertreatment of cardiovascular risk factors in UK primary care among patients at risk of CVD.
很少有研究调查高血压患者中血脂异常的情况。此外，关于同时治疗这两种疾病以预防心血管疾病（CVD）的数据也很少。这项回顾性队列研究调查了英国初级医疗中高血压患者的高血压和血脂异常治疗模式。我们从英国全科医疗研究数据库中定义了年龄≥40岁的患者群体。将具有≥3种额外心血管危险因素（ARFs）的高血压患者与包含≤2种ARFs的高血压患者队列进行比较。我们分析了1997年1月至2001年12月期间危险因素的患病率以及高血压、血脂异常和两种疾病同时存在时的治疗患病率和发病率。1997年共识别出117840名高血压患者（23655名具有≥3种ARFs，94185名具有≤2种ARFs）；2001年，诊断为高血压的人数为133683名（40248名≥3种ARFs，93435名≤2种ARFs）。在研究期间，具有≥3种ARFs的高血压患者中抗高血压治疗的患病率有所增加。2001年，约三分之一具有≥3种ARFs的高血压患者未接受抗高血压药物治疗。在接受此类治疗的患者中，大多数根据当前指南接受了≥2种不同药物治疗。每年在具有≥3种ARFs的高血压患者中，同时患有高血压和血脂异常的患者中开始治疗的比例不到8%。这些发现表明，在英国初级医疗中，有心血管疾病风险的患者对心血管危险因素的认识不足/治疗不足。
