Park C G, Choi C U
Cardiovascular Center, Department of Internal Medicine, Guro Hospital, Korea University, Seoul, Korea.
J Hum Hypertens. 2009 Apr;23(4):252-8. doi: 10.1038/jhh.2008.128. Epub 2008 Oct 30.
Hypertension is the most important single modifiable risk factor of stroke. The purpose of this study was to investigate the distribution patterns of risk factors of stroke and 10-year probability of stroke in hypertensive patients visiting community-based hospitals. A total of 1088 hypertensive patients who visited 61 community-based hospitals nationwide were enrolled. Risk factors of stroke were evaluated using a series of laboratory tests and physical examinations, and the 10-year probability of stroke was determined by applying the Framingham stroke risk equation. The proportion of patients who have uncontrolled hypertension despite the use of antihypertensives was 63.3% (59.6% women, 68.7% men; P=0.006). The average 10-year probability of stroke in hypertensive patients was 16.05% (14.68% women, 17.99% men; P<0.001). The 10-year probability of stroke in patients with hypertension gradually increased in proportion to age. In patients treated with antihypertensives, 10-year probability of stroke gradually increased in proportion to blood pressure. The 10-year risk of stroke in hypertensive patients was approximately 4.6 times higher than that of stroke in the general population. In conclusion, as the 10-year risk of stroke in hypertensive patients was approximately 4.6 times higher than that of stroke in the general population, more aggressive interventions are needed to reduce blood pressure and stroke risk in hypertensive patients.
高血压是卒中最重要的单一可改变风险因素。本研究的目的是调查在社区医院就诊的高血压患者中卒中风险因素的分布模式及10年卒中概率。共纳入了全国61家社区医院的1088例高血压患者。通过一系列实验室检查和体格检查评估卒中风险因素,并应用弗明汉姆卒中风险方程确定10年卒中概率。尽管使用了抗高血压药物但仍有血压控制不佳的患者比例为63.3%(女性59.6%,男性68.7%;P=0.006)。高血压患者的平均10年卒中概率为16.05%(女性14.68%,男性17.99%;P<0.001)。高血压患者的10年卒中概率随年龄增长而逐渐增加。在接受抗高血压药物治疗的患者中,10年卒中概率随血压升高而逐渐增加。高血压患者的10年卒中风险约为普通人群卒中风险的4.6倍。总之,由于高血压患者的10年卒中风险约为普通人群卒中风险的4.6倍,因此需要采取更积极的干预措施来降低高血压患者的血压和卒中风险。