SingHealth Polyclinics - Pasir Ris, Singapore.
Duke-NUS Medical School, Singapore.
Singapore Med J. 2020 Sep;61(9):469-475. doi: 10.11622/smedj.2019102. Epub 2019 Sep 6.
Hypertension and dyslipidaemia are major risk factors for cardiovascular diseases and achieving treatment goals mitigates such risks. This study determined demographic and medication-related factors associated with blood pressure (BP) goal attainment in patients with concomitant hypertension and dyslipidaemia.
This paper is a sub-analysis of the Lipid HEALTH study, a questionnaire survey focusing on adult Asian patients with both dyslipidaemia and hypertension. An interviewer-administered questionnaire was used to obtain demographic and clinical information. Laboratory and prescription data was retrieved from electronic health records. BP goals were defined by international guidelines. Data was audited and analysed, and logistic regression analysis was used to identify factors determining BP goal attainment.
Among the 851 included patients, 49.7% attained their BP goals. 37.0% were on monotherapy, 57.6% on ≥ 2 BP-lowering medications, and 5.4% had no pharmacologic treatment. Among those on pharmacotherapy, 51.2% failed to achieve BP goals. Calcium channel blockers were the most frequently prescribed medications. Attainment of BP goals was significantly associated with: not having Type 2 diabetes mellitus (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.61-3.13); attaining low-density lipoprotein cholesterol goal (OR 2.02, 95% CI 1.45-2.81); being solely on dietary control (OR 2.19, 95% CI 1.09-4.39); and receiving monotherapy (OR 1.71, 95% CI 1.18-2.48).
BP treatment goals were attained by half of the patients with dyslipidaemia and hypertension, and half of those on pharmacotherapy. Type 2 diabetes mellitus and low-density lipoprotein cholesterol control were significantly associated with BP goal attainment.
高血压和血脂异常是心血管疾病的主要危险因素，达到治疗目标可以降低这些风险。本研究旨在确定同时患有高血压和血脂异常的患者中与血压（BP）目标达标相关的人口统计学和药物相关因素。
本研究是血脂健康研究的一项子分析，该研究是一项针对同时患有血脂异常和高血压的亚洲成年患者的问卷调查。采用问卷调查的方式获取人口统计学和临床信息。从电子病历中检索实验室和处方数据。血压目标根据国际指南定义。对数据进行审核和分析，并采用逻辑回归分析确定决定血压目标达标相关的因素。
在 851 名纳入患者中，有 49.7%的患者达到了血压目标。37.0%的患者接受单一药物治疗，57.6%的患者接受≥2 种降压药物治疗，5.4%的患者未进行药物治疗。在接受药物治疗的患者中，有 51.2%的患者未能达到血压目标。钙通道阻滞剂是最常开的药物。达到血压目标与以下因素显著相关：无 2 型糖尿病（比值比[OR]2.27，95%置信区间[CI]1.61-3.13）；达到低密度脂蛋白胆固醇目标（OR 2.02，95%CI 1.45-2.81）；仅接受饮食控制（OR 2.19，95%CI 1.09-4.39）；接受单一药物治疗（OR 1.71，95%CI 1.18-2.48）。
血脂异常和高血压患者中只有一半达到血压治疗目标，接受药物治疗的患者中也只有一半达到目标。2 型糖尿病和低密度脂蛋白胆固醇控制与血压目标达标显著相关。
