Blood Purification Center, Keiaikai Chibana Clinic , Okinawa, Japan.
Health Administration Center, University of the Ryukyus , Okinawa, Japan.
Clin Exp Hypertens. 2021 Apr 3;43(3):263-269. doi: 10.1080/10641963.2020.1860079. Epub 2020 Dec 25.
Although numerous studies have demonstrated a strong association between blood pressure (BP) and hemorrhagic complications of antithrombotic therapy, there is still a paucity of information regarding the status of BP control in hypertensive patients on antithrombotic therapy. This cross-sectional, retrospective study was conducted at an outpatient clinic to examine BP control and its associated factors in hypertensive patients receiving or not receiving antithrombotic therapy. Of 26,803 outpatients who had scheduled visits in 2018, 7,800 hypertensive patients met the inclusion criteria, of whom 1,727 cases were on oral antithrombotic drugs. Then, target BP values were defined according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension 2019. While BP values <140/90 mmHg were observed in 63.0% and 61.6% of patients with and without antithrombotic therapy, respectively, only 31.1% and 23.4% of them displayed BP values <130/80 mmHg. Multivariable logistic analysis indicated that comorbidity with obesity was a significant correlate of insufficient BP control (target BP <130/80 mmHg) in hypertensive patients, irrespective of antithrombotic therapy (patients with antithrombotic therapy, odds ratio (OR) = 1.690, 95% confidence interval (CI) = 1.351-2.113; patients without antithrombotic therapy, OR = 1.475, 95% CI = 1.290-1.687). The majority of patients exhibited BP values <140/90 mmHg, whereas BP values <130/80 mmHg were achieved only in a small proportion of the patients. Furthermore, obesity appeared to be one of the factors contributing to insufficient BP control in a real-world setting.
尽管大量研究表明血压（BP）与抗血栓治疗的出血并发症之间存在很强的关联，但关于接受抗血栓治疗的高血压患者的 BP 控制状况的信息仍然很少。这项横断面、回顾性研究在门诊进行，旨在检查接受或不接受抗血栓治疗的高血压患者的 BP 控制及其相关因素。在 2018 年预约就诊的 26803 名门诊患者中，符合纳入标准的高血压患者有 7800 例，其中 1727 例正在服用口服抗血栓药物。然后，根据 2019 年日本高血压学会高血压管理指南定义目标 BP 值。虽然接受和不接受抗血栓治疗的患者的 BP 值分别为<140/90mmHg 的比例分别为 63.0%和 61.6%，但只有 31.1%和 23.4%的患者 BP 值<130/80mmHg。多变量逻辑分析表明，无论是否接受抗血栓治疗，合并肥胖症是高血压患者 BP 控制不足（目标 BP<130/80mmHg）的一个显著相关因素（接受抗血栓治疗的患者，比值比（OR）=1.690，95%置信区间（CI）=1.351-2.113；未接受抗血栓治疗的患者，OR=1.475，95%CI=1.290-1.687）。大多数患者的 BP 值<140/90mmHg，但只有一小部分患者的 BP 值<130/80mmHg。此外，肥胖似乎是导致现实环境中 BP 控制不足的因素之一。
