Moreira Gisela C, Cipullo José P, Martin José F Vilela, Ciorlia Luiz A S, Godoy Maria R P, Cesarino Claudia B, Cordeiro José A, Lupino Plínio L, Ciorlia Gustavo, Burdmann Emmanuel A
Internal Medicine Department, State Medical School of São José Rio Preto, São Paulo, Brazil.
J Hypertens. 2009 Sep;27(9):1900-7. doi: 10.1097/HJH.0b013e32832dd10f.
Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality. The aims of this study were to evaluate the level of awareness and control of hypertension comparing sex, socioeconomic and educational level, BMI and drug therapy in over 40-year-old patients. The cost-effectiveness of the main pharmacologic classes of antihypertensives, as monotherapy and combination therapy, was also assessed.
In this randomized and cross-sectional populational study, a sample of 738 hypertensive adults with ages at least 40 years were evaluated. Of these, 345 (46.7%) were men and 393 (53.3%) were women.
A total of 72.9% of the hypertensives knew about their disease. Women in the 40-49 and 50-59 age groups and obese individuals had a higher rate of awareness of their hypertensive status. The rates of awareness were similar in different social classes and educational levels, however, blood pressure control varied. beta-Blockers were the most effective drugs to control blood pressure with no differences being observed between monotherapy and combinations. Diuretics were the most cost-effective.
Approximately half of the participants received monotherapy. The best percentage of control with monotherapy was obtained with beta-blockers but the diuretics treatment was the most cost-effective. The levels of awareness and control were high compared with developed countries, most evident in the higher social classes and higher education levels.
高血压是全球一种高度流行的疾病,是心血管发病和死亡的主要危险因素之一。本研究的目的是评估40岁以上患者中高血压的知晓和控制水平,比较性别、社会经济和教育水平、体重指数(BMI)及药物治疗情况。还评估了主要抗高血压药物类别作为单一疗法和联合疗法的成本效益。
在这项随机横断面人群研究中,对738名年龄至少40岁的高血压成年人样本进行了评估。其中,345名(46.7%)为男性,393名(53.3%)为女性。
共有72.9%的高血压患者知晓自己的病情。40 - 49岁和50 - 59岁年龄组的女性以及肥胖个体对高血压状态的知晓率较高。不同社会阶层和教育水平的知晓率相似,但血压控制情况有所不同。β受体阻滞剂是控制血压最有效的药物,单一疗法和联合疗法之间未观察到差异。利尿剂是最具成本效益的。
约一半参与者接受单一疗法。单一疗法中β受体阻滞剂的控制率最佳,但利尿剂治疗最具成本效益。与发达国家相比,知晓和控制水平较高,在较高社会阶层和较高教育水平中最为明显。