Pan Heng-Yu, Lin Hung-Ju, Chen Wen-Jone, Wang Tzung-Dau
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City.
Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Acta Cardiol Sin. 2020 Jul;36(4):375-381. doi: 10.6515/ACS.202007_36(4).20191220A.
Inadequate awareness and control remain the major obstacles for hypertension management worldwide. This observational study intended to assess the current status of hypertension management in Taiwan.
The Taiwan May Measurement Month (MMM) campaign was a nationwide survey for public alertness to hypertension initiated in 2017 and conducted in local pharmacies. Participants were asked about body habitus, comorbidities, smoking/drinking, use of anti-hypertensive drugs, and frequency of self-measured blood pressure (SMBP) monitoring. Three blood pressure (BP) readings were then measured by trained pharmacists. The mean BP was obtained by averaging all readings.
BP recordings were obtained from 49,522 participants (average age, 56.9 ± 16.0 years), of whom 26.1% had an elevated pharmacist-measured BP (≥ 140/90 mmHg). The rate of BP control, defined as pharmacist-measured BP < 140/90 mmHg at the MMM visit, was 63.1% among treated hypertensive participants (n = 21,410). Participants who had uncontrolled hypertension were associated with a higher body mass index, currently smoking/drinking, diabetes, and stroke. More active SMBP monitoring (≥ weekly) was more often implemented in the participants with advanced age and cardiovascular diseases. More active SMBP (≥ weekly) was associated with lower measured BP among treated hypertensive participants but not overall control rate (control rate: 56.4% for ≥ weekly vs. 55.8% for < weekly, p = 0.363).
In the Taiwan MMM 2017, the hypertension control rate surpassed 60% in treated hypertensive participants. Suboptimal BP control was related to cardiovascular risk factors and prior stroke. Treated hypertensives had a lower measured BP but similar hypertension control rate for more active versus less active SMBP.
认识不足和控制不力仍是全球高血压管理的主要障碍。这项观察性研究旨在评估台湾高血压管理的现状。
台湾五月量血压月（MMM）活动是一项于2017年发起的全国性调查，旨在提高公众对高血压的警觉，调查在当地药店进行。参与者被询问身体状况、合并症、吸烟/饮酒情况、使用降压药物情况以及自我测量血压（SMBP）监测的频率。然后由经过培训的药剂师测量三次血压读数。通过对所有读数求平均值得到平均血压。
共获得49522名参与者（平均年龄56.9±16.0岁）的血压记录，其中26.1%的参与者经药剂师测量血压升高（≥140/90 mmHg）。在接受治疗的高血压参与者（n = 21410）中，血压控制率（定义为在MMM访视时经药剂师测量血压<140/90 mmHg）为63.1%。高血压未得到控制的参与者与较高的体重指数、当前吸烟/饮酒、糖尿病和中风有关。年龄较大和患有心血管疾病的参与者更常进行更积极的SMBP监测（≥每周一次）。在接受治疗的高血压参与者中，更积极的SMBP（≥每周一次）与较低的测量血压相关，但与总体控制率无关（控制率：≥每周一次为56.4%，<每周一次为55.8%，p = 0.363）。
在2017年台湾MMM活动中，接受治疗的高血压参与者的高血压控制率超过60%。血压控制不佳与心血管危险因素和既往中风有关。对于接受治疗的高血压患者，更积极与较不积极的SMBP相比，测量血压较低，但高血压控制率相似。
