Journath Gunilla, Hellénius Mai-Lis, Petersson Ulla, Theobald Holger, Nilsson Peter M
Department of Neurobiology, Care Sciences and Society, Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):258-62. doi: 10.1097/HJR.0b013e3282f37a45.
To evaluate potential sex differences, this study aimed to investigate blood pressure and lipid control and other risk factors for cardiovascular disease in treated hypertensive (tHT) patients from primary healthcare.
This cross-sectional survey of tHT patients was carried out between 2002 and 2005 by 264 primary care physicians from Sweden who consecutively recruited 6537 tHT patients (48% men and 52% women) from medical records.
tHT men more often reached the treatment goal for systolic/diastolic blood pressure, less than 140/90 mmHg, than tHT women (30 vs. 26%, P<0.01). Men had lower systolic blood pressure than women, however, women had lower diastolic blood pressure and higher pulse pressure. More tHT women had total cholesterol>or=5.0 mmol/l than corresponding men (75 vs. 64% P<0.001). Men more often had diabetes (25 vs. 20% P<0.001), left ventricular hypertrophy (20 vs. 16% P<0.001), and microalbuminuria (24 vs. 16% P<0.001). Women were more often treated with diuretics (64 vs. 48%) and beta-receptor blockers (54 vs. 51%), and men more often treated with angiotensin-converting enzyme inhibitors (27 vs. 18%), calcium channel blockers (34 vs. 26%), and lipid-lowering drugs (34 vs. 29%).
A need still exists for more intensified treatment of elevated blood pressure and hypercholesterolemia, especially in women. In hypertensives of both sexes, smoking and other risk factors also need to be addressed to reduce the risk of cardiovascular disease.
为评估潜在的性别差异,本研究旨在调查基层医疗中接受治疗的高血压(tHT)患者的血压和血脂控制情况以及其他心血管疾病风险因素。
2002年至2005年间,来自瑞典的264名初级保健医生对tHT患者进行了这项横断面调查,他们从病历中连续招募了6537名tHT患者(男性占48%,女性占52%)。
与tHT女性相比,tHT男性更常达到收缩压/舒张压治疗目标(低于140/90 mmHg)(30%对26%,P<0.01)。男性的收缩压低于女性,然而,女性的舒张压较低,脉压较高。总胆固醇≥5.0 mmol/l的tHT女性比相应男性更多(75%对64%,P<0.001)。男性患糖尿病(25%对20%,P<0.001)、左心室肥厚(20%对16%,P<0.001)和微量白蛋白尿(24%对16%,P<0.001)的情况更常见。女性更常使用利尿剂(64%对48%)和β受体阻滞剂(54%对51%)进行治疗,而男性更常使用血管紧张素转换酶抑制剂(27%对18%)、钙通道阻滞剂(34%对26%)和降脂药物(34%对29%)进行治疗。
对于血压升高和高胆固醇血症,尤其是女性,仍需要更强化的治疗。在男女高血压患者中,也需要解决吸烟和其他风险因素以降低心血管疾病风险。