巴基斯坦一家三级护理医院中，南亚裔人群的抗高血压治疗情况

Spectrum of antihypertensive therapy in South Asians at a tertiary care hospital in Pakistan.

作者信息

Almas Aysha, Ur Rehman Iqbal Salik, Ehtamam Anabia, Khan Aamir Hameed

机构信息

Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.

出版信息

BMC Res Notes. 2011 Sep 1;4:318. doi: 10.1186/1756-0500-4-318.

DOI:10.1186/1756-0500-4-318

PMID:21884613

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3171374/

Abstract

BACKGROUND

Despite available guidelines on hypertension (HTN), use of antihypertensives is variable. This study was designed to ascertain frequency of patients on monotherapy and > 1 antihypertensive therapy and also to ascertain proportion of patients on diuretic therapy.

METHODS

It was a crossectional study conducted on 1191 adults(age > 18 yrs)hypertensive patients selected by computerized International Classification of Diseases -9-coordination and maintenance (ICD-9-CM) presenting to a tertiary care hospital in Pakistan. Data on demographics, comorbids, type of antihypertensive drug, number of antihypertensive drug and mean duration of antihypertensive drug was recorded over 1.5 year period (2008-09). Blood pressure was recorded on admission. Primary outcome was use of combination therapy and secondary outcome was use of diuretic therapy.

RESULTS

A total of 1191 participants were included. Mean age(SD) was 62.55(12.47) years, 45.3%(540) were males. Diabetes was the most common comorbid; 46.3%(551). Approximately 85% of patients had controlled hypertension. On categorization of anti hypertensive use into 3 categories;41.2%(491) were on monotherapy,32.2%(384) were on 2 drug therapy,26.5%(316) were on ≥3 drug therapy. Among those who were on monotherapy for HTN;34%(167) were on calcium channel blockers,30.10%(148) were on beta blockers, 22.80%(112) were on Angiotensin converting enzyme (ACE) inhibitors,12%(59) were on diuretics and 2.20%(11) were on Angiotensin receptor blockers(ARB). Use of combination antihypertensive therapy was significantly high in patients with ischemic heart disease(IHD)(p < 0.001). Use of diuretics was in 31% (369) patients. Use of diuretics was significantly less in patients with comorbids of diabetes (p 0.02), Chronic kidney disease(CKD)(p 0.003), IHD (p 0.001) respectively

CONCLUSION

Most patients presenting to our tertiary care center were on combination therapy. Calcium channel blocker is the most common anti hypertensive drug used as monotherapy and betablockers are used as the most common antihypertensive in combination. Only a third of patients were on diuretic as an antihypertensive therapy.

摘要

背景

尽管有关于高血压（HTN）的可用指南，但抗高血压药物的使用情况各不相同。本研究旨在确定接受单一疗法和一种以上抗高血压治疗的患者的频率，并确定接受利尿剂治疗的患者比例。

方法

这是一项横断面研究，对1191名年龄大于18岁的成年高血压患者进行，这些患者通过计算机化的国际疾病分类-9协调与维护（ICD-9-CM）筛选出来，就诊于巴基斯坦的一家三级护理医院。在1.5年期间（2008 - 2009年）记录了人口统计学、合并症、抗高血压药物类型、抗高血压药物数量和抗高血压药物的平均使用时长等数据。入院时记录血压。主要结局是联合治疗的使用情况，次要结局是利尿剂治疗的使用情况。

结果

共纳入1191名参与者。平均年龄（标准差）为62.55（12.47）岁，45.3%（540名）为男性。糖尿病是最常见的合并症，占46.3%（551名）。约85%的患者高血压得到控制。将抗高血压药物的使用分为三类：41.2%（491名）接受单一疗法，32.2%（384名）接受两种药物治疗，26.5%（316名）接受≥3种药物治疗。在接受高血压单一疗法的患者中，34%（167名）使用钙通道阻滞剂，30.10%（148名）使用β受体阻滞剂，22.80%（112名）使用血管紧张素转换酶（ACE）抑制剂，12%（59名）使用利尿剂,2.20%（11名）使用血管紧张素受体阻滞剂（ARB）。缺血性心脏病（IHD）患者联合使用抗高血压治疗的比例显著较高（p < 0.001）。31%（369名）患者使用利尿剂。糖尿病（p = 0.02）、慢性肾脏病（CKD）（p = 0.003）、IHD（p = 0.001）合并症患者使用利尿剂的比例分别显著较低。