Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza (Milan), Italy.
Clinica Medica, Ospedale San Gerardo dei Tintori, Monza (Milan), Italy.
Curr Hypertens Rep. 2018 Jul 26;20(10):82. doi: 10.1007/s11906-018-0885-8.
The paper examines the patterns of BP control achieved in two large scale observational studies, i.e., the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study and the Blood Pressure control rate and CArdiovascular Risk profilE (BP-CARE), carried out in the general population and in treated hypertensive patients, respectively.
It is well known that only a minor fraction among the treated hypertensive patients exhibits a good blood pressure control. However, few study investigated blood pressure control on the basis not only of office, but also home and ambulatory blood pressure measurement, examining its impact on organ damage. In the whole sample of the PAMELA study, only in about 21.1% of cases treated hypertensive subjects exhibit a well-controlled office BP. Control of systolic blood pressure was rarer than the diastolic one. Control of home and, even more, ambulatory blood pressure was more frequent. Left ventricular mass was not normalized even when blood pressure was adequately controlled. Most subjects of BP-CARE study show high or very high cardiovascular risk, due to concomitant risk factors and organ damage. The percentage of well-treated hypertensive patients is lower when CV risk is higher.
本文考察了两项大规模观察性研究中血压控制的模式,即动脉血压监测与相关因素研究(PAMELA 研究)和血压控制率及心血管风险评估研究(BP-CARE 研究),这两项研究分别在普通人群和高血压患者中进行。
众所周知,仅有少数接受治疗的高血压患者血压控制良好。然而,很少有研究不仅基于诊室血压,还基于家庭血压和动态血压测量来评估血压控制情况,并探讨其对器官损害的影响。在 PAMELA 研究的全部样本中,仅有约 21.1%的接受治疗的高血压患者的诊室血压得到了良好控制。收缩压的控制比舒张压更为罕见。家庭血压、甚至动态血压的控制更为频繁。即使血压得到充分控制,左心室质量也未恢复正常。BP-CARE 研究的大多数患者由于并存的危险因素和器官损害而具有较高或极高的心血管风险。心血管风险越高,血压控制良好的高血压患者比例越低。