Department of Cardiology, Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
Department of Cardiology, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12, Wulumuqi Rd. (middle), Shanghai, 200040, China.
Lipids Health Dis. 2019 Jan 29;18(1):32. doi: 10.1186/s12944-019-0974-y.
ᅟ: The present study comprised 17,096 Chinese hypertensive dyslipidemia patients who received lipid-lowering treatment for > 3 months in order to investigate blood pressure (BP) as well as low-density lipoprotein cholesterol (LDL-C) goal attainment rates in Chinese hypertensive dyslipidemia patients on antidyslipidemia drugs. The factors that interfered with BP, or BP and LDL-C goal attainment rates and antihypertensive treatment patterns, were analyzed. In total, 89.9% of the 17,096 hypertensive dyslipidemia patients received antihypertensive medications mainly consisting of a calcium channel blocker (CCB) (48.7%), an angiotensin receptor antagonist (ARB) (25.4%) and an angiotensin-converting enzyme inhibitor (ACEI) (15.1%). In cardiology departments, usage rates of β-blockers (19.2%) were unusually high compared to other departments (4.0-8.3%), whereas thiazide diuretics were prescribed at the lowest rate (0.3% vs 1.2-3.6%). The overall goal attainment rates for combined BP and LDL-C as well as BP or LDL-C targets were 22.9, 31.9 and 60.1%, respectively. The lowest BP, LDL-C and BP combined with LDL-C goal attainment rates were achieved in endocrine departments (19.9, 48.9 and 12.4%, respectively). Combination therapies showed no benefit particularly for BP goal achievement. A multivariate logistic regression analysis showed that age < 65 years, alcohol consumption, diabetes, coronary heart disease (CHD), cerebrovascular disease (CVD), chronic kidney disease (CKD), body mass index (BMI) ≥ 28 kg/m and not achieving total cholesterol goals were independent predictors for achieving BP, LDL-C or combined BP and LDL-C goals. In summary, the BP and LDL-C goal achievement rates in Chinese dyslipidemia outpatients with hypertension were low, especially in endocrine departments. Combination therapies were not associated with improvement of the goal achievement rates. TRIAL REGISTRATION: Clinical trial registration number NCT01732952.
本研究纳入了 17096 例接受降脂治疗超过 3 个月的中国高血压伴血脂异常患者,旨在调查中国高血压伴血脂异常患者在使用降脂药物时血压(BP)和低密度脂蛋白胆固醇(LDL-C)达标率。分析了影响 BP 或 BP 和 LDL-C 达标率以及降压治疗模式的因素。共有 17096 例高血压伴血脂异常患者接受了降压药物治疗,主要包括钙通道阻滞剂(CCB)(48.7%)、血管紧张素受体拮抗剂(ARB)(25.4%)和血管紧张素转换酶抑制剂(ACEI)(15.1%)。心内科β受体阻滞剂(19.2%)的使用率明显高于其他科室(4.0-8.3%),而噻嗪类利尿剂的使用率最低(0.3%比 1.2-3.6%)。BP 和 LDL-C 联合以及 BP 或 LDL-C 目标的总体达标率分别为 22.9%、31.9%和 60.1%。内分泌科 BP、LDL-C 和 BP 联合 LDL-C 达标率最低(分别为 19.9%、48.9%和 12.4%)。联合治疗对 BP 达标没有特别的益处。多变量 logistic 回归分析显示,年龄<65 岁、饮酒、糖尿病、冠心病(CHD)、脑血管病(CVD)、慢性肾脏病(CKD)、体重指数(BMI)≥28kg/m2和未达到总胆固醇目标是达到 BP、LDL-C 或 BP 和 LDL-C 联合目标的独立预测因素。综上所述,中国高血压伴血脂异常门诊患者 BP 和 LDL-C 达标率较低,尤其是在内分泌科。联合治疗与达标率的提高无关。试验注册:临床试验注册号 NCT01732952。