De Backer Guy, Petrella Robert J, Goudev Assen R, Radaideh Ghazi Ahmad, Rynkiewicz Andrzej, Pathak Atul
Department of Public Health, Ghent University Hospital, DePintelaan 185, 9000 Ghent, Belgium.
Int J Hypertens. 2013;2013:165789. doi: 10.1155/2013/165789. Epub 2013 Jul 25.
Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. The Physicians' Observational Work on patient Education according to their vascular Risk (POWER) survey was an open-label investigation of eprosartan-based therapy (EBT) for control of high blood pressure in primary care centers in 16 countries. A prespecified element of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the Systematic Coronary Risk Evaluation (SCORE) model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718 patients in 15 countries (6504 men) and from 9577 patients at 6 months. During EBT mean (±SD) systolic/diastolic blood pressures declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4 mmHg. This was accompanied by a 38% reduction in mean SCORE-estimated CVD risk and an improvement in SCORE risk classification of one category or more in 3506 patients (36.6%). Conclusion. Experience in POWER affirms that (a) effective pharmacological control of blood pressure is feasible in the primary care setting and is accompanied by a reduction in total CVD risk and (b) the SCORE instrument is effective in this setting for the monitoring of total CVD risk.
背景。高血压是心血管疾病的一个重要风险因素。设计与方法。医生根据血管风险进行患者教育的观察性研究（POWER）调查是一项在16个国家的基层医疗中心开展的关于依普罗沙坦治疗（EBT）控制高血压的开放标签研究。该研究的一个预先设定的内容是评估EBT对通过系统性冠状动脉风险评估（SCORE）模型确定的致命心血管事件估计10年风险的影响。结果。在15个国家的12718名患者（6504名男性）基线时以及9577名患者在6个月时获得了心血管疾病风险的SCORE估计值。在EBT期间，平均（±标准差）收缩压/舒张压从160.2±13.7/94.1±9.1mmHg降至134.5±11.2/81.4±7.4mmHg。这伴随着SCORE估计的心血管疾病风险平均降低38%，并且3506名患者（36.6%）的SCORE风险分类改善了一个类别或更多。结论。POWER研究的经验证实：（a）在基层医疗环境中有效药物控制血压是可行的，并且伴随着总心血管疾病风险的降低；（b）SCORE工具在这种环境下对于监测总心血管疾病风险是有效的。
