Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and Hypertension Unit, Hospital Doce de Octubre, c/Arzobispo Morcillo 2, 28029 Madrid, Spain.
Hypertension. 2012 Oct;60(4):898-905. doi: 10.1161/HYPERTENSIONAHA.112.193078. Epub 2012 Sep 4.
Despite the importance of achieving cardiometabolic goals beyond blood pressure, in the health of hypertensives, no comprehensive assessment of these characteristics has been performed in whole countries. We studied in 2008-2010 a total of 11 957 individuals representative of the Spanish population aged≥18 years. Information on cardiometabolic characteristics was collected at the participants' homes, through structured questionnaires, physical examination, and fasting blood samples. A total of 3983 individuals (33.3%) had hypertension (≥140/90 mm Hg or current antihypertensive drug treatment), 59.4% were aware of their condition, 78.8% treated among those aware, and 48.5% controlled among those aware and treated (22.7% of all hypertensives). Of the aware hypertensives, 13.8% had a body mass index<25 kg/m2, 38.6% consumed <2.4 g/d of sodium, 19.3% were diabetic with 61% attaining goal hemoglobin A1c<6.5%, whereas 42.3% had hypercholesterolemia, with 38.1% reaching goal low-density lipoprotein<115 mg/dL. Only 30.7% of overweight patients received a prescription of specific method for weight loss, 17.4% of daily smokers were offered a smoking cessation strategy, and 15.8% of older patients were given a flu shot. Aware and unaware hypertensives showed a similar frequency of some lifestyle, such as adequate physical activity. In conclusion, in a European country with a well-developed, free-access healthcare system, achievement of many cardiometabolic goals among hypertensives is poor. Moreover, a serious deficiency in hypertension awareness and in the effectiveness of some lifestyle interventions among aware hypertensives is present. Greater effort is needed in the management of coexisting risk factors and on lifestyle medical advice to improve the cardiometabolic health of hypertensives.
尽管实现超越血压的心血管代谢目标对于高血压患者的健康至关重要，但在整个国家范围内，尚未对这些特征进行全面评估。我们于 2008-2010 年对总共 11957 名年龄≥18 岁的西班牙代表性人群进行了研究。通过结构化问卷、体格检查和空腹血样，在家中收集心血管代谢特征信息。共有 3983 人（33.3%）患有高血压（≥140/90mmHg 或正在服用降压药物），59.4%的患者知晓自己的病情，在知晓的患者中，78.8%接受了治疗，在知晓且接受治疗的患者中，48.5%得到了控制（所有高血压患者的 22.7%）。在知晓的高血压患者中，13.8%的体重指数<25kg/m2，38.6%的钠摄入量<2.4g/d，19.3%患有糖尿病，其中 61%的糖化血红蛋白目标值<6.5%，而 42.3%的患者胆固醇水平升高，其中 38.1%的低密度脂蛋白<115mg/dL。仅有 30.7%的超重患者接受了减肥特定方法的处方，17.4%的每日吸烟者被提供了戒烟策略，15.8%的老年患者被接种了流感疫苗。知晓和不知晓的高血压患者在某些生活方式方面的频率相似，例如进行足够的身体活动。总之，在一个拥有发达、免费医疗保健系统的欧洲国家，高血压患者实现许多心血管代谢目标的情况较差。此外，高血压意识不足，以及在知晓的高血压患者中某些生活方式干预措施的有效性也存在严重不足。需要在管理并存的危险因素和生活方式医疗建议方面付出更多努力，以改善高血压患者的心血管代谢健康。
