Bhagavathula Akshaya Srikanth, Shah Syed Mahboob, Suliman Abubaker, Oulhaj Abderrahim, Aburawi Elhadi Husein
Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain P.O. Box 17666, Abu Dhabi, United Arab Emirates.
Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain P.O. Box 17666, Abu Dhabi, United Arab Emirates.
J Clin Med. 2021 Dec 23;11(1):47. doi: 10.3390/jcm11010047.
(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07-1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08-1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03-1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.
(1) 背景：本研究旨在评估新治疗的高血压队列在开始治疗的前6个月内血压（BP）的变化，并确定与实现美国（ACC/AHA，2017）、欧洲（ESC/ESH，2018）、英国（NICE，2019）和国际高血压学会（ISH，2020）指南推荐的血压目标相关的因素。(2) 方法：我们分析了2017年阿联酋阿布扎比的5308例初发高血压门诊患者；每位患者随访6个月。根据ACC/AHA指南，高血压定义为血压130/80 mmHg，根据ESC/ESH、NICE和ISH指南，高血压定义为血压140/90 mmHg。采用多因素logistic回归分析确定与实现指南推荐的血压目标相关的因素。(3) 结果：基线时平均血压为133.9±72.9 mmHg，6个月时为132.7±72.5 mmHg。根据ACC/AHA、ESC/ESH、NICE和ISH指南，指南推荐的血压目标达成率分别为39.5%、43%、65.6%和40.8%。根据ACC/AHA（优势比（OR）=1.26；95%置信区间（CI）=1.07 - 1.49）、ESC/ESH（OR = 1.27；95% CI = 1.08 - 1.50）和ISH指南（OR = 1.22；95% CI = 1.03 - 1.44），体重指数<25 kg/m²与更好的血压控制相关。在二级医疗机构接受治疗的高血压患者更有可能实现ACC/AHA（1.31倍）、ESC/ESH（1.32倍）、NICE（1.41倍）和ISH（1.34倍）指南推荐的血压目标。(4) 结论：血压目标达成情况不理想。血压控制措施应优先改善心脏代谢目标和生活方式改变。
