Swiss Cardiovascular Center Bern, University Hospital Bern, 3010 Bern, Switzerland.
Swiss Med Wkly. 2011 Mar 4;141:w13169. doi: 10.4414/smw.2011.13169. eCollection 2011.
Despite a broad and efficient pharmacological antihypertensive armamentarium, blood pressure (BP) control is suboptimal and heterogeneous throughout Europe. Recent representative data from Switzerland are limited. The goal of the present survey was therefore to assess the actual control rate of high BP in Switzerland in accordance with current guidelines. The influence of risk factors, target organ damage and medication on BP levels and control was also evaluated.
A cross-sectional visit-based survey of ambulatory hypertensive patients was performed in 2009 in Switzerland. 281 randomly selected physicians provided data on 5 consecutive hypertensive patients attending their practices for BP follow-up. Data were anonymously collected on demographics, comorbidities and current medication, and BP was recorded. Subsequent modification of pharmacological antihypertensive therapy was assessed.
Data from 1376 patients were available. Mean age was 65 ± 12 years, 53.9% were male subjects. 26.4% had complicated hypertension. Overall, BP control (<140/90 mm Hg for uncomplicated and <130/80 mm Hg for complicated hypertension) was achieved in 48.9%. Compared to patients with complicated hypertension, BP control was better in patients with uncomplicated hypertension (59.4% vs. 19.2%, p <0.001). As a monotherapy the most prescribed drug class were angiotensin receptor blockers (ARB, 41%), followed by angiotensin converting enzyme (ACE) inhibitors (21.5%), betablockers (20.8%) and calcium channel blockers (CCB, 10.8%). The most prescribed drug combinations were ARB + diuretic (30.1%) and ACE inhibitors + diuretic (15.3%). 46% were receiving a fixed drug combination. In only 32.7% of patients with uncontrolled hypertension was a change in drug therapy made.
This representative survey on treated adult hypertensive patients shows that, compared to earlier reports, the control rate of hypertension has improved in Switzerland for uncomplicated but not for complicated, particularly diabetes-associated hypertension. ARBs and ACE inhibitors are the most prescribed antihypertensive drugs for monotherapy, whereas diuretics and ARBs were the most used for combination therapy.
尽管有广泛而有效的药理学降压武器库，但整个欧洲的血压（BP）控制仍不理想且存在异质性。来自瑞士的最新代表性数据有限。因此，本调查的目的是根据当前指南评估瑞士高血压的实际控制率。还评估了危险因素、靶器官损伤和药物对 BP 水平和控制的影响。
2009 年在瑞士进行了一项基于门诊高血压患者的横断面调查。281 名随机选择的医生提供了在其诊所进行 BP 随访的 5 名连续高血压患者的数据。收集了人口统计学、合并症和当前药物治疗的数据，并记录了 BP。评估了随后对降压药物治疗的修改。
共获得 1376 名患者的数据。平均年龄为 65±12 岁，53.9%为男性。26.4%患有复杂高血压。总体而言，未合并高血压的患者中（<140/90mmHg），血压控制率达到 48.9%。与患有复杂高血压的患者相比，未合并高血压的患者血压控制更好（59.4%对 19.2%，p<0.001）。作为单一疗法，最常开的药物类别是血管紧张素受体阻滞剂（ARB，41%），其次是血管紧张素转换酶抑制剂（ACEI，21.5%）、β受体阻滞剂（20.8%）和钙通道阻滞剂（CCB，10.8%）。最常开的药物组合是 ARB+利尿剂（30.1%）和 ACEI+利尿剂（15.3%）。46%的患者接受固定药物联合治疗。在未控制的高血压患者中，仅有 32.7%改变了药物治疗。
这项针对成年高血压患者的代表性调查显示，与早期报告相比，瑞士未经治疗的高血压控制率有所提高，但复杂高血压，尤其是糖尿病相关高血压的控制率没有提高。ARB 和 ACEI 是用于单一疗法的最常开的降压药物，而利尿剂和 ARB 是用于联合疗法的最常开的药物。
