Shlomai Gadi, Kopel Eran, Goldenberg Ilan, Grossman Ehud
Department of Internal Medicine D and Hypertension Unit, the Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, 2013, the Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Heart Institute and the Neufeld Cardiac Research Institute Leviev Heart Center, the Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Am Soc Hypertens. 2014 Feb;8(2):94-102. doi: 10.1016/j.jash.2013.08.004. Epub 2013 Oct 23.
Our aim was to evaluate trends in blood pressure (BP) management and BP levels among patients admitted with acute coronary syndromes (ACS) over the past decade. The study population comprised 7658 ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) between 2002 and 2010. We compared patients' characteristics, admission systolic BP levels, and antihypertensive therapy between those hospitalized during the early (years: 2002-2004) and late (years: 2008-2010) periods. Among 7658 study participants, 4421 (58%) were hypertensive. Hypertensive patients presenting from 2008 to 2010 tended to exhibit lower BP levels (P < .001). The use of angiotensin converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and beta-blockers has increased over the years (P < .001 for both), whereas the use of diuretics and calcium antagonists has remained stable (P = .77 for both). The use of diuretics tended to increase in hypertensive subjects without prior cardiovascular disease (P = .05). In addition, the late period was characterized by a significant increase in the use of two or more antihypertensive agents (combination therapy) compared with the early period (57% vs 50%; P < .001). BP levels decreased among Israeli hypertensive patients presenting with ACS between 2002 and 2010, possibly due to increased use of ACEi/ARB, and combination therapies during this time period.
我们的目标是评估过去十年中因急性冠脉综合征（ACS）入院患者的血压管理趋势和血压水平。研究人群包括2002年至2010年间纳入以色列急性冠脉综合征调查（ACSIS）的7658例ACS患者。我们比较了早期（2002 - 2004年）和晚期（2008 - 2010年）住院患者的特征、入院收缩压水平和抗高血压治疗情况。在7658名研究参与者中，4421名（58%）为高血压患者。2008年至2010年出现的高血压患者血压水平往往较低（P <.001）。多年来，血管紧张素转换酶抑制剂（ACEi）/血管紧张素受体阻滞剂（ARB）和β受体阻滞剂的使用有所增加（两者P均 <.001），而利尿剂和钙拮抗剂的使用保持稳定（两者P = 0.77）。在无心血管疾病史的高血压患者中，利尿剂的使用有增加趋势（P = 0.05）。此外，与早期相比，晚期使用两种或更多抗高血压药物（联合治疗）的情况显著增加（57%对50%；P <.001）。2002年至2010年间，以色列患有ACS的高血压患者血压水平下降，可能是由于在此期间ACEi/ARB和联合治疗的使用增加。
