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基于土耳其高血压共识报告的治疗选择:我们是否遵循这些建议?

Choice of treatment based on Turkish hypertension consensus report: Do we follow the recommendations?

作者信息

Yürüyen Gülden, Toprak İlkim Deniz, Toprak Zeki, Akarsu Murat, Demir Pınar, Arman Yücel, Çil Eylem Özgün, Özcan Mustafa, Irmak Sedat, Altun Özgür, Aydın Yoldemir Şengül, Eruzun Hasan, Tükek Tufan

机构信息

Department of Internal Medicine, İstanbul Okmeydanı Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2018 Jan;46(1):25-31. doi: 10.5543/tkda.2017.86344.

Abstract

OBJECTIVE

The aim of this study was to determine how often the recommendations of the Turkish Hypertension Consensus Report are followed, and to draw attention to the report.

METHODS

The demographic information of 1000 patients diagnosed with hypertension and the details of the antihypertensive medications prescribed at the outpatient service of a tertiary care hospital were recorded, and the data were compared with the recommendations of the report.

RESULTS

The mean age of the patients was 62±11 years. In all, 623 (62.3%) of the 1000 patients were women, and 377 (37.7%) were men. A combination of an angiotensin II receptor blocker (ARB) and a diuretic was the most frequently observed prescription. A diuretic was the most used antihypertensive drug (58.7%), followed by an ARB (48.8%). However, as a monotherapy, a calcium channel blocker (CCB) was the most commonly used antihypertensive drug (19.2%). The most frequently used antihypertensive drug group in older patients was diuretics (63.6%), as proposed in the report. Beta blockers (49.1%) were used more often than expected. For the diabetic group also, a diuretic (60.7%) was the most frequently used antihypertensive drug, followed by an ARB (51.1%) and a CCB (45.2%). Angiotensin-converting enzyme (ACE) inhibitors (34.6%) were the fifth most preferred antihypertensive drug class. However, when ACE inhibitors and ARBs were considered as a single group, known as renin-angiotensin system (RAS) blockers, these RAS blockers were the most prescribed antihypertensive drug class, followed by diuretics. In the group of patients with coronary artery disease, treatment was found to be generally consistent with the report, but the use of diuretics was greater than expected. Lastly, 124 of 160 patients who had chronic kidney disease were given RAS blocker therapy, which was in line with the consensus report recommendations.

CONCLUSION

Antihypertensive therapies were individualized, as suggested by the consensus report. However, there are proposals still to be considered in special patient groups.

摘要

目的

本研究旨在确定土耳其高血压共识报告的建议被遵循的频率,并引起对该报告的关注。

方法

记录了一家三级护理医院门诊诊断为高血压的1000例患者的人口统计学信息以及所开降压药物的详细情况,并将数据与该报告的建议进行比较。

结果

患者的平均年龄为62±11岁。1000例患者中,共有623例(62.3%)为女性,377例(37.7%)为男性。血管紧张素II受体阻滞剂(ARB)和利尿剂的联合用药是最常观察到的处方。利尿剂是使用最多的降压药物(58.7%),其次是ARB(48.8%)。然而,作为单一疗法,钙通道阻滞剂(CCB)是最常用的降压药物(19.2%)。如报告中所提议的,老年患者中最常用的降压药物组是利尿剂(63.6%)。β受体阻滞剂(49.1%)的使用比预期更频繁。对于糖尿病组,利尿剂(60.7%)也是最常用的降压药物,其次是ARB(51.1%)和CCB(45.2%)。血管紧张素转换酶(ACE)抑制剂(34.6%)是第五大最常用的降压药物类别。然而,当将ACE抑制剂和ARB视为一个单一类别(即肾素-血管紧张素系统(RAS)阻滞剂)时,这些RAS阻滞剂是最常处方的降压药物类别,其次是利尿剂。在冠状动脉疾病患者组中,发现治疗总体上与报告一致,但利尿剂的使用高于预期。最后,160例慢性肾病患者中有124例接受了RAS阻滞剂治疗,这与共识报告的建议一致。

结论

如共识报告所建议的,降压治疗是个体化的。然而,在特殊患者群体中仍有一些建议有待考虑。

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