Llisterri Caro José L, Rodríguez Roca Gustavo C, Alonso Moreno Francisco J, Banegas Banegas José R, González-Segura Alsina Diego, Lou Arnal Salvador, Divisón Garrote Juan A, Sánchez Ruiz Tomás, Santos Rodríguez José A, Barrios Alonso Vivencio
Centro de Salud de Ingeniero Joaquín Benlloch, Valencia, España.
Med Clin (Barc). 2008 May 17;130(18):681-7. doi: 10.1157/13120766.
More information is needed on hypertension control and its evolution in clinical practice. This study aimed to determine the degree of blood pressure (BP) control in Spanish hypertensive patients attended in primary care (PC) and to determine the factors associated with poor BP control.
Cross-sectional, multicenter study, carried out in PC settings throughout Spain. Hypertensive patients >or= 18 years, with antihypertensive treatment (>or= 3 months) were consecutively recruited. BP measurement was performed in surgery hours (morning and evening) following standardized methods and averaging 2 consecutive readings. BP control was regarded as optimum when BP values were < 140/90 mmHg in general population and <130/80 mmHg in patients with diabetes, chronic renal disease or cardiovascular disease.
10,520 hypertensive patients were included (53.7% women), mean age (SD) 64.6 (11.3) years. 41.4% (95% confidence interval [CI], 40.5-42.4) presented good systolic BP (SBP) and diastolic BP (DBP) control, 46.5% (95% CI, 45.5-47.4) only SBP control and 67.1% (95% CI, 66.2-68.0) only DBP control. 55.6% of patients were treated with combination therapy (41.2% 2 drugs, 11.7% 3 and 2.8% more than 3). BP control was significantly (p<0.001) higher in the evening measurement (48.9%) than in the morning measurement (40.5%), and if patients had taken the treatment before measurement (42.0%) compared with those who had not taken it (38.8%). Factors such as diabetes, cardiovascular disease, sedentary lifestyle, alcohol consumption and surgery hour were associated with poor BP control (p<0.001).
The results of the PRESCAP 2006 study indicate that 4 out of 10 hypertensive patients treated in PC in Spain have an optimal BP control. The degree of control of arterial hypertension has improved remarkably with respect to the PRESCAP 2002 study.
在临床实践中,需要更多关于高血压控制及其演变的信息。本研究旨在确定西班牙基层医疗中高血压患者的血压控制程度,并确定与血压控制不佳相关的因素。
在西班牙各地的基层医疗机构开展的横断面多中心研究。连续招募年龄≥18岁、接受抗高血压治疗(≥3个月)的高血压患者。在诊疗时间(上午和晚上)按照标准化方法测量血压,并对连续2次读数取平均值。一般人群血压值<140/90 mmHg,糖尿病、慢性肾病或心血管疾病患者血压值<130/80 mmHg时,视为血压控制理想。
纳入10520例高血压患者(53.7%为女性),平均年龄(标准差)64.6(11.3)岁。41.4%(95%置信区间[CI],40.5 - 42.4)患者收缩压(SBP)和舒张压(DBP)控制良好,46.5%(95% CI,45.5 - 47.4)仅SBP控制良好,67.1%(95% CI,66.2 - 68.0)仅DBP控制良好。55.6%的患者接受联合治疗(41.2%使用2种药物,11.7%使用3种药物,2.8%使用3种以上药物)。晚上测量时血压控制率(48.9%)显著高于上午测量时(40.5%)(p<0.001),测量前服药患者的血压控制率(42.0%)高于未服药患者(38.8%)。糖尿病、心血管疾病、久坐不动的生活方式、饮酒和诊疗时间等因素与血压控制不佳相关(p<0.001)。
PRESCAP 2006研究结果表明,在西班牙基层医疗中接受治疗的高血压患者,每10例中有4例血压控制理想。与PRESCAP 2002研究相比,动脉高血压的控制程度有显著改善。