Department of Medical Science and Welfare, Institute of Community Medicine, University of Tsukuba, Tennoudai 1-1-1, 305-8575, Tsukuba-shi, Ibaraki-ken, Japan.
Environ Health Prev Med. 2002 Nov;7(5):193-8. doi: 10.1007/BF02898004.
Blood pressure (BP) is poorly controlled in many countries. Poor compliance was suggested as the main cause for poor BP control. The purpose of this study was to examine the association between compliance and the control of both casual blood pressure (BP) and 24-hr ambulatory BP in a Japanese elderly population.
The study was a cross-sectional survey. Casual BP and 24-hr ambulatory BP were measured at home. Hypertension was defined as casual systolic BP (SBP)≧140 and/or diastolic BP (DBP)≧90 mmHg, or as treated hypertension. A compliance rate of greater than 80% by the pill count method was defined as good compliance.
Of the 178 treated hypertensives, 82.6% showed good compliance. Between the treated hypertensives with good compliance and those with poor compliance, no significant difference was found in either casual BP or ambulatory BP. Of the treated hypertensives with good compliance, the prevalence of achieved target ambulatory BP, i.e., daytime BP<135/85 mmHg, nighttime BP<120/75 mmHg, and 24-hr BP<125/80 mmHg, was, respectively, 35.4%, 43.5%, and 20.4%.
Casual BP and 24-hr ambulatory BP were poorly controlled in the community-living elderly although many of the treated hypertensives showed good compliance. It is unlikely that this inadequate control of hypertension is due to poor compliance on the part of the subjects.
许多国家的血压（BP）控制不佳。较差的依从性被认为是血压控制不佳的主要原因。本研究旨在探讨日本老年人群中依从性与偶测血压（BP）和 24 小时动态血压控制之间的关系。
该研究为横断面调查。在家中测量偶测血压和 24 小时动态血压。高血压定义为偶测收缩压（SBP）≧140 和/或舒张压（DBP）≧90mmHg，或治疗性高血压。以药片计数法评估的依从率大于 80%定义为良好依从性。
在 178 例接受治疗的高血压患者中，82.6%表现出良好的依从性。在依从性良好和依从性差的治疗性高血压患者之间，偶测 BP 或动态 BP 无显著差异。在依从性良好的治疗性高血压患者中，达到目标动态血压的比例分别为白天血压<135/85mmHg、夜间血压<120/75mmHg 和 24 小时血压<125/80mmHg，分别为 35.4%、43.5%和 20.4%。
尽管许多治疗性高血压患者表现出良好的依从性，但社区居住的老年人偶测血压和 24 小时动态血压控制不佳。高血压控制不足不太可能是由于患者依从性差所致。
