Department of Clinical Pharmacology, Bispebjerg Hospital, København NV, Denmark.
Fam Pract. 2012 Dec;29(6):626-32. doi: 10.1093/fampra/cms031. Epub 2012 May 7.
High blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.
To evaluate the impact of an intervention targeting GPs' management of hypertension.
A cluster randomized trial comprising 124 practices and 2646 patients with hypertension. In the Capital Region of Denmark, the participating GPs were randomized to an intensive or to a moderately intensive intervention group or to a control group and in Region Zealand and Region of Southern Denmark, practices were randomized into a moderately intensive intervention and to a control group. The main outcome measures were change in proportion of patients with high BP and change in systolic BP (SBP) and diastolic BP (DBP) from the first to the second registration.
The proportion of patients with high BP in 2007 was reduced in 2009 by ~9% points. The mean SBP was reduced significantly from 2007 to 2009 by 3.61 mmHg [95% confidence interval (CI): -4.26 to -2.96], and the DBP was reduced significantly by 1.99 mmHg (95% CI: -2.37 to -1.61). There was no additional impact in either of the intervention groups.
There was no impact of the moderate intervention and no additional impact of the intensive intervention on BP.
高血压（BP）是中风最重要的危险因素之一，降压治疗显著降低了心血管发病率和死亡率的风险。然而，高血压患者的血压控制仍然是一个挑战。
评估针对全科医生高血压管理的干预措施的影响。
一项包括 124 个实践和 2646 例高血压患者的集群随机试验。在丹麦首都大区，参与的全科医生被随机分配到强化干预组、适度强化干预组或对照组；在西兰大区和南丹麦大区，实践被随机分配到适度强化干预组和对照组。主要结局指标是从第一次登记到第二次登记时，高血压患者中血压高的比例和收缩压（SBP）和舒张压（DBP）的变化。
2007 年高血压患者中血压高的比例在 2009 年降低了约 9%。SBP 从 2007 年到 2009 年显著降低了 3.61mmHg（95%可信区间：-4.26 至-2.96），DBP 也显著降低了 1.99mmHg（95%可信区间：-2.37 至-1.61）。干预组均未产生额外影响。
适度干预对血压没有影响，强化干预也没有额外影响。
