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全科医疗中高血压及高血压相关脑血管疾病临床管理的态度与偏好:意大利高血压与脑部调查结果

Attitudes and preferences for the clinical management of hypertension and hypertension-related cerebrovascular disease in the general practice: results of the Italian hypertension and brain survey.

作者信息

Tocci Giuliano, Cicero Arrigo F, Salvetti Massimo, Musumeci Maria Beatrice, Ferrucci Andrea, Borghi Claudio, Volpe Massimo

机构信息

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035, Rome, 00189 Italy.

Division of Internal Medicine, University of Bologna, Bologna, Italy.

出版信息

Clin Hypertens. 2017 May 15;23:10. doi: 10.1186/s40885-017-0066-0. eCollection 2017.

Abstract

BACKGROUND

The aim of this survey was to evaluate attitudes and preferences for the clinical management of hypertension and hypertension-related cerebrovascular diseases (CVD) in Italy.

METHODS

A predefined 16-item survey questionnaire was anonymously administered to a large community sample of general practitioners (GPs), trained by specialized physicians (SPs), who have been included in an educational program between January and November 2015.

RESULTS

A total of 591 physicians, among whom 48 (8%) training SPs and 543 (92%) trained GPs, provided 12,258 valid answers to the survey questionnaire. Left ventricular hypertrophy was considered the most frequent marker of hypertension-related organ damage, whereas atrial fibrillation and carotid atherosclerosis were considered relatively not frequent (10-20%). The most appropriate blood pressure (BP) targets to be achieved in hypertensive patients with CVD were <140/90 mmHg for SPs and <135/85 mmHg for GPs. To achieve these goals, ACE inhibitors were considered the most effective strategies by GPs, whereas SPs expressed a preference for ARBs, both in monotherapies and in combination therapies with beta-blockers.

CONCLUSIONS

This survey demonstrates that Italian physicians considered left ventricular hypertrophy frequently associated to CVD and that drugs inhibiting the renin-angiotensin system the most appropriate therapy to manage hypertension and hypertension-related CVD.

摘要

背景

本次调查旨在评估意大利对高血压及高血压相关脑血管疾病(CVD)临床管理的态度和偏好。

方法

一份预先定义的包含16个条目的调查问卷被匿名发放给一个由专科医生(SPs)培训的全科医生(GPs)的大型社区样本,这些全科医生在2015年1月至11月期间参加了一个教育项目。

结果

共有591名医生,其中48名(8%)培训中的专科医生和543名(92%)接受培训的全科医生对调查问卷提供了12258条有效回答。左心室肥厚被认为是高血压相关器官损害最常见的标志,而心房颤动和颈动脉粥样硬化被认为相对不常见(10 - 20%)。对于患有CVD的高血压患者,专科医生认为最合适的血压(BP)目标是<140/90 mmHg,全科医生认为是<135/85 mmHg。为实现这些目标,全科医生认为ACE抑制剂是最有效的策略,而专科医生在单药治疗和与β受体阻滞剂的联合治疗中都更倾向于ARB。

结论

本次调查表明,意大利医生认为左心室肥厚常与CVD相关,并且抑制肾素 - 血管紧张素系统的药物是管理高血压及高血压相关CVD的最合适治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcf4/5430606/2584857fad44/40885_2017_66_Fig1_HTML.jpg

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