Institut de cardiologie d'Abidjan, BP V 206, Abidjan, Ivory Coast.
Arch Cardiovasc Dis. 2011 Nov;104(11):558-64. doi: 10.1016/j.acvd.2011.08.002. Epub 2011 Oct 28.
Elevated blood pressure is one of the most important modifiable risk factors for cardiovascular diseases.
To evaluate blood pressure management in Côte d'Ivoire.
A retrospective study was conducted among 2575 hypertensive patients from the Institute of Cardiology of Abidjan, who were followed for at least 10 years, between January 2000 and December 2009.
The patients' mean age ± standard deviation was 59.1 ± 12.5 years; 54.3% were women. At first presentation, hypertension was stage 1 in 21.7%, stage 2 in 32.3% and stage 3 in 46.0% of patients. According to the European guidelines' stratification of the cardiovascular risk-excess attributable to high blood pressure, 46.7% had a very high added risk, 37.8% had a high added risk and 14.9% had a low-to-moderate added risk. Pharmacological therapy was prescribed in 97.8% of patients; more than 66% were receiving at least two antihypertensive drugs, including fixed-dose combination drugs. The most common agents used were diuretics (59.7%) followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (59.6%). The most common agents for monotherapy were calcium antagonists. When two or more drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were most commonly used. Blood pressure control was achieved in 43.7% of cases.
In our series, severe hypertension with high added risk or very high added risk was very common. Treatment--mostly diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers--required at least two antihypertensive drugs to meet the recommended blood pressure target.
高血压是心血管疾病最重要的可改变危险因素之一。
评估科特迪瓦的血压管理情况。
对 2000 年 1 月至 2009 年 12 月期间在阿比让心脏病学研究所接受至少 10 年随访的 2575 例高血压患者进行回顾性研究。
患者的平均年龄 ± 标准差为 59.1 ± 12.5 岁；54.3%为女性。初次就诊时，21.7%的患者为 1 期高血压，32.3%为 2 期高血压，46.0%为 3 期高血压。根据欧洲指南对高血压引起的心血管风险增加程度的分层，46.7%的患者存在极高的附加风险，37.8%的患者存在高附加风险，14.9%的患者存在低至中度附加风险。97.8%的患者接受了药物治疗；超过 66%的患者接受了至少两种降压药，包括固定剂量联合药物。最常用的药物是利尿剂（59.7%），其次是血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（59.6%）。单药治疗最常用的药物是钙通道阻滞剂。当使用两种或更多种药物时，最常用的是利尿剂和血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂。43.7%的病例血压得到控制。
在我们的研究系列中，严重高血压伴高附加风险或极高附加风险非常常见。治疗——主要是利尿剂和血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂——需要至少两种降压药才能达到推荐的血压目标。
