Wilke Andreas, Steverding Dietmar
Cardiologic Practice Papenburg, Papenburg, Germany.
Norwich Medical School, University of East Anglia, Norwich, UK.
Cardiol Res. 2011 Apr;2(2):79-81. doi: 10.4021/cr36e. Epub 2011 Mar 25.
Hypertension is a widespread chronic condition which is usually treated with hypertensive drugs. However, 50% of hypertensive patients do not achieve control of their blood pressure below the standard target of 140/90 mmHg when treated with a single antihypertensive drug. Generally, hypertension specialists have a key role in managing hypertensive patients.
A retrospective case note review based on observations made in a cardiological outpatient clinic in Germany was carried out to assess whether the recommendation given by hypertension specialists were followed. The aim was to lower the blood pressure to < 130/85 mmHg over a period of six months by administering the new antihypertensive drug Zaneril (lercanidipine/enalapril). Twenty-four hour blood pressure profiles were monitored a fortnight and six months later.
Of the 130 patients, whose average blood pressure was 163/87 mmHg before receiving hypertensive treatment, only 44 (34%) were still on Zaneril therapy six months later. Eighty-four patients (65%) did not turn up for follow-up examinations. The blood pressure of patients who were under Zaneril therapy for the whole six months was better adjusted than that of patients who changed their treatment in the meantime (133/78 mmHg vs. 139/80 mmHg).
Specialists have only little influence on the long-term therapy of hypertensive patients.
高血压是一种常见的慢性疾病，通常采用降压药物进行治疗。然而，在使用单一降压药物治疗时，50%的高血压患者无法将血压控制在140/90 mmHg的标准目标以下。一般来说，高血压专科医生在管理高血压患者方面起着关键作用。
基于在德国一家心脏病门诊的观察结果进行回顾性病例记录审查，以评估高血压专科医生给出的建议是否得到遵循。目的是通过服用新型降压药物扎尼尔（乐卡地平/依那普利）在六个月内将血压降至<130/85 mmHg。在两周和六个月后监测24小时血压曲线。
在130名患者中，接受高血压治疗前平均血压为163/87 mmHg，六个月后只有44名（34%）仍在服用扎尼尔治疗。84名患者（65%）未前来进行随访检查。在整个六个月内接受扎尼尔治疗的患者血压调整得比在此期间更换治疗的患者更好（133/78 mmHg对139/80 mmHg）。
专科医生对高血压患者的长期治疗影响很小。
