Tocci Giuliano, Cicero Arrigo F, Salvetti Massimo, Passerini Jasmine, Musumeci Maria Beatrice, Ferrucci Andrea, Borghi Claudio, Volpe Massimo
Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome "Sapienza", Via di Grottarossa 1035, 00189, Rome, Italy.
IRCCS Neuromed, Pozzilli, IS, Italy.
Intern Emerg Med. 2015 Dec;10(8):943-54. doi: 10.1007/s11739-015-1256-y. Epub 2015 May 19.
Hypertension treatment and control represent a clinical challenge, particularly in case of concomitant risk factors and comorbidities, including chronic obstructive pulmonary disease (COPD). To evaluate attitudes and preferences for the clinical management of hypertension and hypertension associated with COPD by a large community sample of physicians in Italy. A predefined 18-item survey questionnaire was anonymously administered to both specialised physicians (SPs) and general practitioners (GPs), who have been included in an educational programme, performed between January and June 2014. A total of 1181 physicians (767 males, mean age 55.8 ± 7.3 years, average age of medical activity 27.6 ± 8.3 years), among whom 64 (5.4 %) SPs and 1117 (94.6 %) GPs, provided 21,809 valid answers to the survey questionnaire. Concomitant presence of hypertension and COPD was frequently associated (21-40 %) with hypertension-related organ damage and comorbidities. Concomitant presence of hypertension and COPD was able to affect physicians' ability to achieve the recommended therapeutic targets. To achieve the recommended BP goals, ACE inhibitors or ARBs were considered the most effective antihypertensive strategies, both in monotherapies and in combination therapies with either diuretics or calcium-channel blockers. This observational, cross-sectional survey provides useful information on physicians' attitudes and preferences for the clinical management of patients with hypertension and hypertension associated with COPD.
高血压的治疗与控制是一项临床挑战,尤其是在存在包括慢性阻塞性肺疾病(COPD)在内的伴随风险因素和合并症的情况下。为了评估意大利大量社区医生对高血压以及与COPD相关的高血压临床管理的态度和偏好。在2014年1月至6月期间,向纳入一项教育项目的专科医生(SPs)和全科医生(GPs)匿名发放了一份预先定义的包含18个条目的调查问卷。共有1181名医生(767名男性,平均年龄55.8±7.3岁,平均医疗活动年限27.6±8.3年),其中64名(5.4%)为专科医生,1117名(94.6%)为全科医生,对调查问卷提供了21,809份有效答案。高血压与COPD并存常常与高血压相关的器官损害和合并症有关(21%-40%)。高血压与COPD并存会影响医生实现推荐治疗目标的能力。为了实现推荐的血压目标,无论是在单一疗法还是与利尿剂或钙通道阻滞剂的联合疗法中,ACE抑制剂或ARB都被认为是最有效的降压策略。这项观察性横断面调查为医生对高血压以及与COPD相关的高血压患者临床管理的态度和偏好提供了有用信息。