University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Clin Hypertens (Greenwich). 2011 Aug;13(8):598-604. doi: 10.1111/j.1751-7176.2011.00478.x. Epub 2011 Jun 29.
Hypertension is prevalent in the United States and remains uncontrolled. The primary objective of the study was to determine the effect of once-daily dosing of a combination therapy for blood pressure (BP) and dyslipidemia using home BP monitoring on reaching clinical BP and the effect of daily dosing of combination therapy on reaching lipid goals. The study was conducted in middle-aged, indigent, African Americans who had high-risk, resistant hypertension and dyslipidemia. Patients were randomly assigned to either the home and clinic BP group or usual care group and were followed for 6 months. The average BPs for each group were compared and used to titrate the study drug appropriately. Both groups achieved significant declines in BP, total cholesterol, and low-density lipoprotein (LDL) (P<.0001). These findings demonstrate that BP control could be achieved at a rate of 43.5% compared with the 2004 national control rate of 35%. The LDL control rate was also improved. Cardiovascular risk reduction has been proven to be achieved through managing lipids and BP. This trial demonstrates that these goals can be achieved similar to other groups in indigent African Americans with high-risk hypertension and dyslipidemia.
高血压在美国很普遍，但仍未得到控制。该研究的主要目的是通过家庭血压监测来确定每日一次的血压和血脂联合治疗对达到临床血压的影响，以及每日一次的联合治疗对达到血脂目标的影响。该研究在中年、贫困的非裔美国人中进行，这些人患有高危、耐药性高血压和血脂异常。患者被随机分配到家庭和诊所血压组或常规护理组，并随访 6 个月。比较了每个组的平均血压，并适当调整了研究药物的剂量。两组的血压、总胆固醇和低密度脂蛋白（LDL）均显著下降（P<.0001）。这些发现表明，与 2004 年全国 35%的控制率相比，血压控制率可达到 43.5%。LDL 的控制率也有所改善。通过管理血脂和血压已经证明可以降低心血管风险。这项试验表明，在患有高危高血压和血脂异常的贫困非裔美国人中，这些目标可以与其他人群相似地实现。
