Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital.
Department of Medicine II, Charles University in Prague, First Faculty of Medicine.
J Hypertens. 2019 Oct;37(10):2015-2023. doi: 10.1097/HJH.0000000000002130.
Hypertension is the most prevalent major independent risk factor for developing coronary heart disease (CHD). The present analysis aimed to assess blood pressure (BP) distribution and factors associated with insufficient BP control in coronary patients from 24 countries participating in the European Society of Cardiology (ESC) EURoObservational Research Programme (EORP) EUROASPIRE IV survey.
EUROASPIRE IV is a cross-sectional study conducted in 2012-2013 in patients aged 80 years or less hospitalized for CHD with a follow-up visit at a median of 16 months later. Logistic regression analysis was applied to confirm factors associated with BP control defined as less than 140/90 mmHg for nondiabetic patients and less than 140/85 mmHg for diabetic patients.
A total of 7998 patients (response rate, 48.7%) attended the follow-up visit. Complete data were available in 7653 participants (mean age 62.5 ± 9.6 years). The BP goal was achieved in 57.6%. Patients failing to achieve the BP goal were older, had higher BMI, had more often a history of coronary artery bypass grafting (CABG) and reported diabetes more frequently. Logistic regression confirmed the following independent significant predictors of not achieving the BP goal: a history of diabetes [odds ratio (OR) 1.75], obesity (OR 1.70 vs. normal BMI), overweight (OR 1.28 vs. normal BMI), age at least 65 years (OR 1.53) and CABG as the index event (OR 1.26 vs. acute MI).
EUROASPIRE IV found insufficient BP control in a large proportion of patients with stable CHD, with diabetes, increased BMI, older age and CABG as the index event being independent predictors of poor BP control.
高血压是导致冠心病(CHD)的最常见的主要独立危险因素。本分析旨在评估来自 24 个参与欧洲心脏病学会(ESC)EURoObservational Research Programme(EORP)EUROASPIRE IV 调查的国家的冠心病患者的血压(BP)分布和与血压控制不足相关的因素。
EUROASPIRE IV 是一项在 2012 年至 2013 年进行的横断面研究,对象为因 CHD 住院且年龄在 80 岁以下的患者,中位随访时间为 16 个月。应用 logistic 回归分析来确认与血压控制相关的因素,血压控制的定义为非糖尿病患者的血压低于 140/90mmHg,糖尿病患者的血压低于 140/85mmHg。
共有 7998 例患者(应答率为 48.7%)参加了随访。7653 例参与者(平均年龄 62.5±9.6 岁)的数据完整。57.6%的患者达到了血压目标。未达到血压目标的患者年龄更大,BMI 更高,有更多的冠状动脉旁路移植术(CABG)病史,且更常报告患有糖尿病。logistic 回归证实了以下不能达到血压目标的独立显著预测因素:糖尿病病史(比值比 [OR] 1.75)、肥胖(OR 1.70 与正常 BMI 相比)、超重(OR 1.28 与正常 BMI 相比)、年龄至少 65 岁(OR 1.53)和 CABG 作为索引事件(OR 1.26 与急性心肌梗死相比)。
EUROASPIRE IV 发现,稳定型 CHD 患者中,很大一部分患者血压控制不足,糖尿病、BMI 增加、年龄较大和 CABG 作为索引事件是血压控制不佳的独立预测因素。