大多数血压控制目标以上的患者仅接受一种或两种降压药物治疗。

Most individuals with treated blood pressures above target receive only one or two antihypertensive drug classes.

机构信息

St Vincent's Institute of Medical Research, Melbourne, Victoria, Australia.

出版信息

Intern Med J. 2013 Feb;43(2):137-43. doi: 10.1111/j.1445-5994.2012.02927.x.

DOI:10.1111/j.1445-5994.2012.02927.x

PMID:22909211

Abstract

BACKGROUND

A significant proportion of individuals taking antihypertensive therapies fail to achieve blood pressures <140/90 mmHg. In order to develop strategies for improved treatment of blood pressure, we examined the association of blood pressure control with antihypertensive therapies and clinical and lifestyle factors in a cohort of adults at increased cardiovascular risk.

METHODS

A cross-sectional study of 3994 adults from Melbourne and Shepparton, Australia enrolled in the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study. Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, atrial fibrillation, cerebrovascular disease, renal impairment or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. The main outcome measures were the proportion of participants receiving antihypertensive therapy with blood pressures ≥140/90 mmHg and the association of blood pressure control with antihypertensive therapies and clinical and lifestyle factors.

RESULTS

Of 3623 participants (1975 men and 1648 women) receiving antihypertensive therapy, 1867 (52%) had blood pressures ≥140/90 mmHg. Of these 1867 participants, 1483 (79%) were receiving only one or two antihypertensive drug classes. Blood pressures ≥140/90 mmHg were associated with increased age, male sex, waist circumference and log amino-terminal-pro-B-type natriuretic peptide levels.

CONCLUSIONS

Most individuals with treated blood pressures above target receive only one or two antihypertensive drug classes. Prescribing additional antihypertensive drug classes and lifestyle modification may improve blood pressure control in this population of individuals at increased cardiovascular risk.

摘要

背景

相当一部分服用抗高血压药物的患者血压未能降至<140/90mmHg。为了制定改善血压治疗的策略，我们在一个心血管风险增加的成年人群中研究了血压控制与抗高血压治疗以及临床和生活方式因素的关系。

方法

这是一项来自澳大利亚墨尔本和谢帕顿的 3994 名成年人的横断面研究，他们参加了 SCReening Evaluation of the Evolution of New Heart Failure（SCREEN-HF）研究。纳入标准为年龄≥60 岁，有或无自述缺血性或其他心脏病、心房颤动、脑血管病、肾功能损害或≥2 年的高血压或糖尿病治疗史。排除标准为已知心力衰竭或超声心动图或其他影像学检查的心脏异常。主要观察指标为接受抗高血压治疗且血压≥140/90mmHg的参与者比例，以及血压控制与抗高血压治疗以及临床和生活方式因素的关系。

结果

在 3623 名接受抗高血压治疗的参与者（1975 名男性和 1648 名女性）中，有 1867 名（52%）血压≥140/90mmHg。在这 1867 名参与者中，有 1483 名（79%）仅接受一种或两种抗高血压药物治疗。血压≥140/90mmHg与年龄较大、男性、腰围和氨基末端前 B 型利钠肽水平升高有关。