Guo Qing-Hua, Pan Chang-Yu, Qi Wen-Hang, Lin Shan-Yan
Department of Endocrinology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2008 Jan 22;88(4):240-4.
To prospectively evaluate the current situation of blood pressure control in the type 2 diabetics in some regions of China.
Totally 5063 consecutive patients with hypertension were investigated. Among them 1993 with diabetes underwent baseline survey. Individualized target blood pressures were set by physicians. Four follow-up visits, in weeks 2, 4, 8, and 12 were performed to monitor the achievements of these targets and the reasons for not modifying antihypertensive treatments were analyzed when the blood pressure goals were not reached.
The prevalence of diabetes among the hypertensive patients was 39.2%. The target blood pressure values defined by the physicians at baseline survey varied with the grade and degree of hypertension. 31.4% of the patients reached the target blood pressure goals (BP < 130/80 mm Hg) at week 12. The reasons for not intensifying antihypertensive treatment when the blood pressure targets were not achieved were manifold. The main reasons were as follows: the physicians considered that the BP value was close to the target, longer treatment and waiting for full drug effect were needed, etc. On average, 2 different antihypertensive agents were used to achieve BP target and some patients used 4-5 different drugs. The most frequent agents used were angiotensin II receptor antagonist and calcium channel blockers. The use of thiazide-type diuretics increased from the first visit to the last visit (weeks 12).
The co-prevalence of hypertension and diabetes in China is high and the target blood pressure set by physician is almost 130/80 mm Hg as defined in guidelines. Only about 31.4% of patients have reached their goals 12 weeks after treatment. There are many subjective and objective reasons responsible for not intensifying antihypertensive treatment when the blood pressure targets are not achieved. Hypertension in diabetes is poorly controlled compared with that in the whole population.
前瞻性评估中国部分地区2型糖尿病患者的血压控制现状。
共调查5063例连续性高血压患者。其中1993例糖尿病患者接受了基线调查。医生设定个体化血压目标。在第2、4、8和12周进行4次随访，以监测这些目标的达成情况，并分析血压目标未达成时未调整降压治疗的原因。
高血压患者中糖尿病患病率为39.2%。医生在基线调查时确定的目标血压值因高血压的分级和程度而异。31.4%的患者在第12周达到目标血压值（血压<130/80 mmHg）。血压目标未达成时未强化降压治疗的原因是多方面的。主要原因如下：医生认为血压值接近目标，需要更长时间的治疗并等待药物充分起效等。平均使用2种不同的降压药物来实现血压目标，一些患者使用4 - 5种不同药物。最常用的药物是血管紧张素II受体拮抗剂和钙通道阻滞剂。噻嗪类利尿剂的使用从首次就诊到最后一次就诊（第12周）有所增加。
中国高血压与糖尿病的共患病率较高，医生设定的目标血压与指南中定义的几乎一样为130/80 mmHg。治疗12周后只有约31.4%的患者达到目标。血压目标未达成时未强化降压治疗存在许多主观和客观原因。与总体人群相比，糖尿病患者的高血压控制不佳。
Zotero 插件