Ohta Yuko, Tsuchihashi Takuya, Kiyohara Kanako
Division of Hypertension, Clinical Research Institute, National Kyushu Medical Center, Japan.
Intern Med. 2011;50(19):2107-12. doi: 10.2169/internalmedicine.50.5321. Epub 2011 Oct 1.
Lifestyle modification as well as combination antihypertensive therapy is necessary to achieve strict blood pressure (BP) control as advocated by the guidelines for the treatment of hypertension. The aim of this study was to investigate the status of adherence to lifestyle modifications and BP control status in hypertensive outpatients.
Subjects are 661 hypertensive outpatients who had been followed at National Kyushu Medical Center. We assessed BP control status based on the average clinic BP on two occasions. In addition, we investigated the adherence to the individual items of lifestyle modification by a questionnaire.
Average BP was 129 ± 10/71 ± 11 mmHg and overall rate of achieving goal BP was 60.1%. Achieving rate of each target BP category was 83.3% in the elderly patients (<140/90 mmHg), 56.7% in the young/middle patients (<130/85 mmHg) and 45.5% in the patients with diabetes mellitus/chronic kidney disease/myocardial infarction (<130/80 mmHg). Adherance to each item of lifestyle modification was as follows: Patients who answered to be conscious about salt restriction was 80.9%, those with increased intake of fruits/vegetables was 79.0%, reduced intake of cholesterol/saturated fatty acids was 67.9%, presence of obesity was 37.7%, daily exercise for ≥30 min was 31.9%, habitual alcohol intake was 38.0%, habitual smoking was 9.8%. Only 22.5% of the patients had no lifestyle items to be modified. On the other hand, 19.6% of patients had more than 3 items to be modified. Subjects with more than 3 lifestyle items to be modified are more frequently found in young, male, and obese groups.
We conclude that about 60% of the patients achieved goal BP by the intensive combination therapy. The lifestyle modification seems to be important especially for the young, male and obese patients.
按照高血压治疗指南的倡导，进行生活方式改变以及联合抗高血压治疗对于实现严格的血压控制是必要的。本研究的目的是调查高血压门诊患者生活方式改变的依从性状况以及血压控制状况。
研究对象为661名在国立九州医疗中心接受随访的高血压门诊患者。我们基于两次门诊平均血压评估血压控制状况。此外，我们通过问卷调查来调查生活方式改变各项内容的依从性。
平均血压为129±10/71±11 mmHg，总体血压达标率为60.1%。各目标血压类别在老年患者（<140/90 mmHg）中的达标率为83.3%，在中青年患者（<130/85 mmHg）中为56.7%，在糖尿病/慢性肾脏病/心肌梗死患者（<130/80 mmHg）中为45.5%。生活方式改变各项内容的依从性如下：回答有意识限制盐摄入的患者为80.9%，增加水果/蔬菜摄入量的患者为79.0%，减少胆固醇/饱和脂肪酸摄入量的患者为67.9%，存在肥胖的患者为37.7%，每天锻炼≥30分钟的患者为31.9%，有习惯性饮酒的患者为38.0%，有习惯性吸烟的患者为9.8%。只有22.5%的患者没有需要改变的生活方式项目。另一方面，19.6%的患者有超过3项需要改变的项目。在年轻、男性和肥胖组中，有超过3项生活方式项目需要改变的受试者更为常见。
我们得出结论，约60%的患者通过强化联合治疗实现了血压目标。生活方式改变似乎尤为重要，特别是对于年轻、男性和肥胖患者。
