抗高血压药物治疗依从性与血压变异性的关系。
Association between antihypertensive medication adherence and visit-to-visit variability of blood pressure.
机构信息
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
出版信息
J Clin Hypertens (Greenwich). 2013 Feb;15(2):112-7. doi: 10.1111/jch.12037. Epub 2012 Nov 28.
Abstract
It has been hypothesized that high visit-to-visit variability (VVV) of systolic blood pressure (SBP) may be the result of poor antihypertensive medication adherence. The authors studied this association using data from 1391 individuals taking antihypertensive medication selected from a large managed care organization. The 8-item Morisky Medication Adherence Scale, administered during 3 annual surveys, captured self-report adherence, with scores<6, 6 to <8, and 8 representing low, medium. and high adherence, respectively. The mean (standard deviation [SD]) for SD of SBP across study visits was 12.9 (4.4), 13.5 (4.8), and 14.1 (4.5) mm Hg in participants with high, medium, and low self-reported adherence, respectively. After multivariable adjustment and compared with those with high self-report adherence, SD of SBP was 0.60 (95% confidence interval, 0.13-1.07) and 1.08 (95% confidence interval, 0.29-1.87) mm Hg higher among participants with medium and low self-report adherence, respectively. Results were consistent when pharmacy fill was used to define adherence. These data suggest that low antihypertensive medication adherence explains only a small proportion of VVV of SBP.
摘要
有人假设，收缩压（SBP）的就诊间变异性（VVV）高可能是降压药物治疗依从性差的结果。作者使用从大型管理式医疗组织中选择的 1391 名服用降压药物的个体的数据研究了这种关联。在 3 项年度调查中使用了 8 项 Morisky 药物依从性量表来评估自我报告的依从性，得分<6、6 至<8 和 8 分别代表低、中、高依从性。高、中、低自我报告依从性的参与者的 SBP 就诊间标准差（SD）分别为 12.9（4.4）、13.5（4.8）和 14.1（4.5）mmHg。经过多变量调整后，与高自我报告依从性的参与者相比，中、低自我报告依从性的参与者的 SBP 就诊间 SD 分别高 0.60（95%置信区间，0.13-1.07）和 1.08（95%置信区间，0.29-1.87）mmHg。当使用药房配药来定义依从性时，结果是一致的。这些数据表明，降压药物治疗的低依从性仅能解释 SBP VVV 的一小部分。
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