Divisón-Garrote J A, Prieto-Díaz M Á, Alonso-Moreno F J, Velilla-Zancada S M, Escobar-Cervantes C, Llisterri-Caro J L, Cinza-Sanjurjo S, Rodríguez-Roca G C, Polo-García J, Pallarés-Carratalá V
Centro de Salud Casas Ibañez, Albacete, Spain; Director Cátedra de Medicina de Familia SEMERGEN, Universidad Católica San Antonio de Murcia, Spain.
Centro de Salud Vallobín-La Florida, Oviedo, Spain; Doctorando en Facultad de Medicina, Cátedra Universidad Santiago de Compostela - SEMERGEN, Spain.
Semergen. 2020 Mar;46(2):107-114. doi: 10.1016/j.semerg.2019.07.003. Epub 2019 Aug 5.
To determine the prevalence of hypotension and associated factors in hypertensive patients treated in the Primary Care setting.
A cross-sectional, descriptive, and multicentre study was conducted with a total of 2635 general practitioners consecutively including 12,961 hypertensive patients treated in a Primary Care setting in Spain. An analysis was performed on the variables of age, gender, weight, height, body mass index, waist circumference, cardiovascular risk factors (diabetes, dyslipidaemia, smoking, obesity, sedentary lifestyle), fasting plasma glucose, complete lipid profile, as well as the presence of target organ damage (left ventricular hypertrophy, microalbuminuria, carotid atherosclerosis) and associated clinical conditions. Hypotension was defined as a systolic blood pressure less than 110mmHg or a diastolic blood pressure less than 70mmHg. A multivariate analysis was performed to determine the variables associated with the presence of hypotension.
The mean age was 66.2 years, and 51.7% of patients were women. The mean time of onset of hypertension was 9.1 years. A total of 13.1% of patients (95% confidence interval 12.4-13.6%) had hypotension, 95% of whom had low diastolic blood pressure. The prevalence of hypotension was higher in elderly patients (25.7%) and in those individuals with coronary heart disease (22.6%). The variables associated with the presence of hypotension included a history of cardiovascular disease, being treated with at least 3 antihypertensive drugs, diabetes, and age.
One out of 4-5 elderly patients, or those with cardiovascular disease, had hypotension. General practitioners should identify these patients in order to determine the causes and adjust treatment to avoid complications.
确定在基层医疗环境中接受治疗的高血压患者低血压的患病率及相关因素。
开展了一项横断面、描述性多中心研究，连续纳入了2635名全科医生，共涉及西班牙基层医疗环境中治疗的12961名高血压患者。对年龄、性别、体重、身高、体重指数、腰围、心血管危险因素（糖尿病、血脂异常、吸烟、肥胖、久坐不动的生活方式）、空腹血糖、完整血脂谱以及靶器官损害（左心室肥厚、微量白蛋白尿、颈动脉粥样硬化）和相关临床状况等变量进行了分析。低血压定义为收缩压低于110mmHg或舒张压低于70mmHg。进行多变量分析以确定与低血压存在相关的变量。
平均年龄为66.2岁，51.7%的患者为女性。高血压的平均发病时间为9.1年。共有13.1%的患者（95%置信区间12.4 - 13.6%）患有低血压，其中95%的患者舒张压较低。老年患者（25.7%）和冠心病患者（22.6%）的低血压患病率较高。与低血压存在相关的变量包括心血管疾病史、接受至少3种抗高血压药物治疗、糖尿病和年龄。
4 - 5名老年患者或患有心血管疾病的患者中就有1人患有低血压。全科医生应识别这些患者，以确定病因并调整治疗，避免并发症。
