Kjeldsen Sverre E, Naditch-Brule Lisa, Perlini Stefano, Zidek Walter, Farsang Csaba
Department of Cardiology, Ullevaal Hospital, Norway.
J Hypertens. 2008 Oct;26(10):2064-70. doi: 10.1097/HJH.0b013e32830c45c3.
The Global Cardiometabolic Risk Profile in Patients with hypertension disease survey investigated the cardiometabolic risk profile in adult outpatients with hypertension in Europe according to the control of blood pressure (BP) as defined in the European Society of Hypertension and of the European Society of Cardiology (ESH/ESC) guidelines.
Data on BP control and cardiometabolic risk factors were collected for 3370 patients with hypertension in 12 European countries. Prevalence was analyzed according to BP status and ATP III criteria for metabolic syndrome.
BP was controlled (BP < 140/90 mmHg for nondiabetic patients; BP < 130/80 mmHg for diabetic patients) in 28.1% of patients. Patients with uncontrolled BP had significantly higher mean weight, BMI, waist circumference, fasting blood glucose, total cholesterol and triglycerides and high-density lipoprotein cholesterol levels were significantly lower (women only) compared with patients with controlled BP (P < 0.05). The prevalence of metabolic syndrome and type 2 diabetes was also significantly higher in patients with uncontrolled BP compared with controlled BP (P < 0.001) (metabolic syndrome: 66.5 versus 35.5%; diabetes 41.1 versus 9.8%, respectively). 95.3% of patients with both metabolic syndrome and type 2 diabetes had uncontrolled BP. In a multivariate analysis, diabetes and metabolic syndrome were found to be associated with a high risk of poor BP control: odds ratio, 2.56 (metabolic syndrome); 5.16 (diabetes).
In this European study, fewer than one third of treated hypertensive patients had controlled BP. Metabolic syndrome and diabetes were important characteristics associated with poor BP control. Thus, more focus is needed on controlling hypertension in people with high cardiometabolic risk and diabetes.
高血压疾病患者全球心血管代谢风险概况调查,根据欧洲高血压学会和欧洲心脏病学会(ESH/ESC)指南中定义的血压(BP)控制情况,对欧洲成年高血压门诊患者的心血管代谢风险概况进行了调查。
收集了12个欧洲国家3370例高血压患者的血压控制和心血管代谢危险因素数据。根据血压状态和代谢综合征的ATP III标准分析患病率。
28.1%的患者血压得到控制(非糖尿病患者血压<140/90 mmHg;糖尿病患者血压<130/80 mmHg)。与血压得到控制的患者相比,血压未得到控制的患者平均体重、BMI、腰围、空腹血糖、总胆固醇和甘油三酯显著更高,高密度脂蛋白胆固醇水平显著更低(仅女性)(P<0.05)。与血压得到控制的患者相比,血压未得到控制的患者代谢综合征和2型糖尿病的患病率也显著更高(P<0.001)(代谢综合征:66.5%对35.5%;糖尿病分别为41.1%对9.8%)。同时患有代谢综合征和2型糖尿病的患者中,95.3%血压未得到控制。在多变量分析中,发现糖尿病和代谢综合征与血压控制不佳的高风险相关:比值比,2.56(代谢综合征);5.16(糖尿病)。
在这项欧洲研究中,接受治疗的高血压患者中不到三分之一血压得到控制。代谢综合征和糖尿病是与血压控制不佳相关的重要特征。因此,需要更加关注控制心血管代谢风险高的人群和糖尿病患者的高血压。