Sicras-Mainar Antoni, Fernández de Bobadilla Jaime, Navarro-Artieda Ruth, Rejas-Gutiérrez Javier
Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España.
Aten Primaria. 2010 Aug;42(8):420-30. doi: 10.1016/j.aprim.2009.09.027. Epub 2010 Feb 8.
Mediterranean populations are traditionally considered to be associated with lower incidence of cardiovascular events (CVE). However, this might not be homogeneous throughout different patient strata. The goal was to compare the incidence of CVE and all-causes mortality in hypertensive patients with an ASCOT-type profile with that of the rest hypertensive subjects.
A retrospective analysis was carried out using a claim database. Hypertensive patients without known cardiovascular disease on antihypertensive therapy included during year 2006 were followed up for two consecutive years to ascertain the incidence of all-causes mortality and any CVE. CVE included any of the following: coronary heart disease, acute myocardial infarction (AMI), angina, stroke, transient ischemic attack (TIA) and peripheral artery disease. Patients with ASCOT and ASCOT-LLA type profiles were identified and compared with non-ASCOT-type profile hypertensive subjects.
A total of 11,104 were included in the analysis; 68.0+/-11.4 years, 41.6% males. More than 73% of subjects fulfilled criteria for ASCOT-type profile. All-causes mortality were numerically higher in ASCOT and ASCOT-LLA subjects compared with non-ASCOT-type; hazard ratio (95% CI)=1.3 (0.8-1.9) and 1.6 (0.9-2.8), respectively. However, any-coronary event rate was significantly higher in ASCOT-type [2.3 (1.8-2.8), p<0.001], as well as in ASCOT-LLA subjects [1.8 (1.3-2.4), p<0.001].
Hypertensive patients on treatment with ASCOT-type profile are more likely to have any cardiovascular event than those hypertensive patients without ASCOT profile in a Mediterranean setting in Spain.
传统上认为地中海地区人群心血管事件(CVE)的发病率较低。然而,在不同患者群体中情况可能并非如此。本研究旨在比较具有ASCOT型特征的高血压患者与其他高血压患者的CVE发病率及全因死亡率。
使用索赔数据库进行回顾性分析。对2006年接受抗高血压治疗且无已知心血管疾病的高血压患者进行连续两年的随访,以确定全因死亡率和任何CVE的发生率。CVE包括以下任何一种:冠心病、急性心肌梗死(AMI)、心绞痛、中风、短暂性脑缺血发作(TIA)和外周动脉疾病。识别出具有ASCOT和ASCOT-LLA型特征的患者,并与非ASCOT型特征的高血压患者进行比较。
共有11104例患者纳入分析;年龄68.0±11.4岁,男性占41.6%。超过73%的受试者符合ASCOT型特征标准。ASCOT和ASCOT-LLA受试者的全因死亡率在数值上高于非ASCOT型受试者;风险比(95%CI)分别为1.3(0.8 - 1.9)和1.6(0.9 - 2.8)。然而,ASCOT型患者的任何冠心病事件发生率显著更高[2.3(1.8 - 2.8),p<0.001],ASCOT-LLA受试者也是如此[1.8(1.3 - 2.4),p<0.001]。
在西班牙地中海地区,接受ASCOT型治疗的高血压患者比无ASCOT特征的高血压患者更易发生任何心血管事件。