护士主导的严格高血压控制诊所是有效的长期治疗手段：一项 7 年随访研究。

Nurse-led clinics for strict hypertension control are effective long term: a 7 year follow-up study.

机构信息

Aintree University Hospitals, Liverpool, UK.

出版信息

Diabet Med. 2010 Aug;27(8):933-7. doi: 10.1111/j.1464-5491.2010.03039.x.

DOI:10.1111/j.1464-5491.2010.03039.x

PMID:20653752

Abstract

AIMS

The primary aim was to assess long-term blood pressure in 110 patients with Type 2 diabetes who had achieved optimal blood pressure control during attendance at a protocol-based nurse-led hypertension intensive intervention clinic 7 years previously. The secondary aim was to assess modifiable cardiovascular risk factor status.

METHODS

One hundred and ten patients who attended the clinic during 2000-2002 were selected to reattend to have their blood pressure measured to the same standard as it was during the intensive intervention clinic, by the same specialist nurse. Treatment details were recorded.

RESULTS

Of the 110 patients, 36 (33%) had died; 69 (63%) of the remaining 74 patients were eligible to be contacted by letter; and 35 (51%) agreed to reattend. Age was 70 +/- 9 years; 21 (60%) were male; and the duration of diabetes was 17 +/- 7 years. Compared with 7 years previously, there was no difference in blood pressure control (systolic 130 +/- 17 vs. 131 +/- 16 mmHg, P = 0.62; diastolic 68 +/- 9 vs. 65 +/- 9 mmHg, P = 0.11). The number of patients with blood pressure <130/80 mmHg remained the same: 17 (49%) vs. 17 (49%; P > 0.99). During the 7 year period, 14 (40%) vs. 20 (57%) had macrovascular disease (P = 0.23), and 14 (40%) vs. 19 (54%) microvascular disease (P = 0.33). Thirteen (37%) vs. 18 (51%) were taking three or more antihypertensive drugs (P = 0.33), and 26 (74%) vs. 28 (80%) angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (P = 0.77).

CONCLUSIONS

Optimal blood pressure control was sustained with no significant changes to antihypertensive medication, demonstrating the effectiveness of a protocol-based nurse-led clinic in achieving strict BP control.

摘要

目的

本研究的主要目的是评估 110 例 2 型糖尿病患者在参加基于方案的护士主导的高血压强化干预诊所 7 年后，长期血压控制情况。次要目的是评估可改变的心血管危险因素状况。

方法

选择 2000-2002 年期间在该诊所就诊的 110 例患者，由同一名专科护士按照相同的标准测量血压，以评估强化干预诊所时的血压。记录治疗详情。

结果

110 例患者中，36 例（33%）死亡；74 例存活患者中，69 例（63%）符合信件联络条件；35 例（51%）同意复诊。患者年龄为 70±9 岁；21 例（60%）为男性；糖尿病病程为 17±7 年。与 7 年前相比，血压控制情况无差异（收缩压 130±17 与 131±16mmHg，P=0.62；舒张压 68±9 与 65±9mmHg，P=0.11）。血压<130/80mmHg 的患者人数保持不变：17 例（49%）与 17 例（49%），P>0.99。7 年内，14 例（40%）与 20 例（57%）发生大血管疾病（P=0.23），14 例（40%）与 19 例（54%）发生微血管疾病（P=0.33）。13 例（37%）与 18 例（51%）服用 3 种或更多种降压药（P=0.33），26 例（74%）与 28 例（80%）服用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（P=0.77）。