在巴斯托婴儿潮人群中，降压和降脂治疗的应用不足。

Under-use of appropriate blood pressure-lowering and lipid-lowering therapy in the Busselton baby boomer population.

机构信息

BPharm, MD, medical student, School of Medicine, The University of Notre Dame, WA.

PhD, Professor, Faculty of Health and Medical Sciences, School of Population and Global Health, The University of Western Australia, WA.

出版信息

Aust J Gen Pract. 2019 Dec;48(12):883-889. doi: 10.31128/AJGP-07-19-4996.

DOI:10.31128/AJGP-07-19-4996

PMID:31774993

Abstract

BACKGROUND AND OBJECTIVES

Data are sparse on how well the absolute risk approach is implemented in primary healthcare. The aim of this study was to quantify absolute cardiovascular disease (CVD) risk, appropriate use of blood pressure (BP)-lowering and lipid-lowering therapy, and clinical target responses in the Busselton baby boomer population.

METHOD

This was a cross-sectional study of 5107 people aged 45-69 years (54.6% female) who participated in the 2010-2015 Busselton Healthy Ageing Study.

RESULTS

Overall, 16.1% of participants had prior CVD (5.8%) or a high primary CVD risk (10.3%). The frequency of use of a guideline-recommended combination of BP-lowering and lipid-lowering therapy was 46.2% in participants with prior CVD, compared with only 16.8% in those with high primary CVD risk (P <0.001). Among the high-risk participants who were receiving recommended combination therapy, only 42.7% achieved target systolic BP levels and 42.1% achieved target total cholesterol levels.

DISCUSSION

These data confirm substantial under treatment of Australian adults who are at high CVD risk. Enhanced implementation of absolute CVD risk assessment and evidence-based treatment in high-risk adults has potential for substantial health gains.

摘要

背景和目的

关于初级保健中绝对风险方法的实施情况的数据很少。本研究的目的是量化心血管疾病（CVD）的绝对风险、降压和降脂治疗的适当应用以及巴瑟尔顿婴儿潮一代人群的临床靶标反应。

方法

这是一项横断面研究，纳入了 5107 名年龄在 45-69 岁的参与者（54.6%为女性），他们参加了 2010-2015 年的巴瑟尔顿健康老龄化研究。

结果

总体而言，16.1%的参与者有既往 CVD（5.8%）或高初级 CVD 风险（10.3%）。在有既往 CVD 的参与者中，使用指南推荐的降压和降脂联合治疗的频率为 46.2%，而在高初级 CVD 风险的参与者中仅为 16.8%（P<0.001）。在接受推荐联合治疗的高危参与者中，只有 42.7%达到目标收缩压水平，42.1%达到目标总胆固醇水平。