难治性高血压：一所大学门诊随访患者的患病率及概况

Resistant hypertension: Prevalence and profile of patients followed in a university ambulatory.

作者信息

Moura Ana Flávia, Moura-Neto José A, Rodrigues Cibele Isaac Saad, Miranda Mariana O, Carvalho Tulio Coelho, Paschoalin Carvalho Nathalia Pereira, Souza Edison, Moura-Jr José A, Cruz Constança Margarida S

机构信息

Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.

Clínica de Nefrologia de Serrinha, Serrinha, Bahia, Brazil.

出版信息

SAGE Open Med. 2021 Jun 12;9:20503121211020892. doi: 10.1177/20503121211020892. eCollection 2021.

DOI:10.1177/20503121211020892

PMID:34178337

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8202308/

Abstract

BACKGROUND

Hypertension affects about 36 million Brazilians. It is estimated that 10%-20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events.

OBJECTIVE

To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension.

METHODS

Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil.

RESULTS

A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD ± 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group.

CONCLUSION

The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown ("pardos") patients in the population studied, and also because the study was performed in a specialized outpatient clinic.

摘要

背景

高血压影响着约3600万巴西人。据估计，其中10%-20%患有顽固性高血压。这些患者早期靶器官损害以及心血管和肾脏事件的风险增加。

目的

评估一家专科门诊中顽固性高血压的患病率，描述这些患者的社会人口统计学和临床特征，并确定与顽固性高血压相关的可能因素。

方法

在获得伦理批准声明后，收集2014年3月至2014年12月在一所专科大学诊所接受优化剂量口服抗高血压药物治疗的高血压患者的病历数据。所有患者均使用优化剂量的适当抗高血压药物，并在巴西巴伊亚医学院和公共卫生学院内科的教学辅助诊所接受治疗。

结果

共纳入104例患者，31.7%（n = 33）符合顽固性高血压标准。在所有参与者中，75.7%为女性，54.8%为黑人或棕色人种。平均年龄为61.7岁（标准差±10.1）。在顽固性高血压组中，63.6%患有糖尿病，而高血压组为32.4%。在顽固性高血压患者中，51.5%患有血脂异常。关于药物治疗，顽固性高血压组75.8%和高血压组51.4%使用他汀类药物。在顽固性高血压患者中，90.9%使用血管紧张素II受体阻滞剂，66.7%使用二氢吡啶类钙通道阻滞剂。在顽固性高血压组中，75.8%使用β受体阻滞剂，而高血压组为25.4%。