Sun Ning-ling, Wang Hong-yi, Huo Yong
Heart Center, Peking University People's Hospital, Beijing 100044, China. Email:nlsun@263.
Zhonghua Nei Ke Za Zhi. 2013 Aug;52(8):654-8.
To investigate blood pressure control the glucose metabolism, cardiovascular risk factors of patients who were regularly followed up at professional hypertension clinics in China.
A cross-sectional survey was conducted in 32 004 patients from 127 professional hypertension clinics across China. The questionnaires included case history and related treatment physical examination and laboratory biochemical tests were also taken at the same time.
The mean blood pressure of overall population was (151 ± 13)/(92 ± 10) mm Hg(1 mm Hg = 0.133 kPa). Totally 3424 patients (10.7%) had never taken any anti-hypertension medicine. Among patients treated with anti-hypertension drugs, 19 818 were of mono-therapy (69.3%) and 8762 were of combination therapy. The most frequently used drug was renin-angiotensin system inhibitor, followed by calcium-channel blocker. Fixed compound preparations accounted for 15.6%. The overall blood pressure control rate (<140/90 mm Hg ) was 26.8%, among them, 27.7%, 30.0%, 25.4% and 21.3% patients were complicated with coronary heart disease, diabetes mellitus, kidney diseases and cerebral stroke respectively. About 70.3% hypertensive patients had abnormal glucose metabolism whose mean glycosylated hemoglobin (GHbA1c) was 7.84%, which was significantly higher than 7.0% , the target value defined by ADA.Even among them, 20.2% patients have never received any anti-diabetic drugs.Low-risk and medium-risk patients accounted for 16.0%. Totally 48.0% patients were classified in high-risk group and 36.0% in very high risk group. About half of all patients had different target organ dysfunction. About 49.0% patients had associated comorbidities.
Co-existence of hypertension and abnormal glucose metabolism is common in Chinese population. Among these patients, target organ dysfunction and comorbidities are prevalent, but blood pressure is only effectively controlled in less than 30% patients. Low proportion of combination therapy is one of the reasons for unsatisfied control of blood pressure.It indicates that effective management of hypertension is urgent.
调查在中国专业高血压诊所定期随访患者的血压控制、糖代谢及心血管危险因素情况。
对来自中国127家专业高血压诊所的32004例患者进行横断面调查。问卷内容包括病史及相关治疗情况，同时进行体格检查和实验室生化检测。
总体人群平均血压为(151±13)/(92±10)mmHg(1mmHg = 0.133kPa)。共有3424例患者(10.7%)从未服用过任何降压药物。在接受降压药物治疗的患者中，19818例采用单药治疗(69.3%)，8762例采用联合治疗。最常用的药物是肾素-血管紧张素系统抑制剂，其次是钙通道阻滞剂。固定复方制剂占15.6%。总体血压控制率(<140/90mmHg)为26.8%，其中合并冠心病、糖尿病、肾脏疾病和脑卒中的患者分别占27.7%、30.0%、25.4%和21.3%。约70.3%的高血压患者存在糖代谢异常，其平均糖化血红蛋白(GHbA1c)为7.84%，显著高于美国糖尿病协会(ADA)定义的目标值7.0%。即使在这些患者中，20.2%的患者从未接受过任何降糖药物治疗。低风险和中风险患者占16.0%。共有48.0%的患者被归类为高风险组，36.0%为极高风险组。约一半的患者存在不同程度的靶器官功能障碍。约49.0%的患者伴有合并症。
高血压与糖代谢异常在中国人群中并存较为常见。在这些患者中，靶器官功能障碍和合并症普遍存在，但血压仅在不到30%的患者中得到有效控制。联合治疗比例低是血压控制不理想的原因之一。这表明高血压的有效管理刻不容缓。
