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高血压、糖尿病及合并症患者血压和空腹血糖的趋势与比较:4年随访数据

Trends and Comparisons of Blood Pressure and Fasting Plasma Glucose in Patients with Hypertension, Diabetes, and Comorbidity: 4-Year Follow-Up Data.

作者信息

Xu Luxinyi, Wen Xiaotong, Yang Ying, Cui Dan

机构信息

School of Public Health, Wuhan University, Wuhan, 430071, People's Republic of China.

Global Health Institute, Wuhan University, Wuhan, 430071, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2022 Nov 25;15:2221-2232. doi: 10.2147/RMHP.S385815. eCollection 2022.

Abstract

BACKGROUND

Patients with both diabetes and hypertension could face more health risks than those with either condition alone, and less attention has been paid to their management outcomes, so this study may be the first to specifically address this problem. We aimed to examine the management outcomes of blood pressure (BP) in hypertensive patients with/without diabetes and fasting plasma glucose (FPG) in diabetic patients with/without hypertension.

METHODS

Follow-up data were obtained from the National Basic Public Health Service Project in Sanming (2017-2021). A total of 25,795 adults with hypertension only, 4111 adults with diabetes only, and 5729 comorbid adults (namely, hypertensive patients with diabetes) were included. Generalized estimating equations were applied.

RESULTS

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension only both dropped significantly (Coef. = -0.00088, < 0.001; Coef. = -0.00081, < 0.001). DBP in comorbid patients decreased considerably (Coef. = -0.00033, < 0.001). Pulse pressure in comorbid patients grew rapidly (Coef. = 0.00044, < 0.001). BP control rate in patients with hypertension only increased significantly (OR = 1.00039, < 0.001). FPG control rates in diabetic patients with/without hypertension grew markedly (OR = 1.00013, < 0.001; OR = 1.00020, < 0.001). Comorbid patients had lower baseline SBP and DBP but higher latest SBP than patients with hypertension only (Coef. = -1.18872, < 0.001; Coef. = -1.16049, < 0.001; Coef. = 1.0634, < 0.001). Comorbid patients had lower baseline BP and FPG control rates than those with either condition alone, and differences were greater at the latest follow-up (OR = 0.28086, < 0.001; OR = 0.91012, = 0.049; OR = 0.04020, < 0.001; OR = 0.69465, < 0.001).

CONCLUSION

BP and FPG management outcomes have achieved progress. Comorbid patients have poorer performance than patients with either disease alone in BP levels especially the SBP level and control rates of SBP, DBP, and FPG. Future studies should be conducted using national data and include more confounding factors.

摘要

背景

糖尿病和高血压并存的患者可能比仅患其中一种疾病的患者面临更多健康风险,而对他们的管理结果关注较少,因此本研究可能是首个专门针对此问题的研究。我们旨在研究合并/未合并糖尿病的高血压患者的血压(BP)管理结果以及合并/未合并高血压的糖尿病患者的空腹血糖(FPG)管理结果。

方法

随访数据来自三明市国家基本公共卫生服务项目(2017 - 2021年)。共纳入25795例仅患高血压的成年人、4111例仅患糖尿病的成年人以及5729例合并症成年人(即糖尿病合并高血压患者)。应用广义估计方程。

结果

仅患高血压患者的收缩压(SBP)和舒张压(DBP)均显著下降(系数 = -0.00088,P < 0.001;系数 = -0.00081,P < 0.001)。合并症患者的DBP显著下降(系数 = -0.00033,P < 0.001)。合并症患者的脉压迅速上升(系数 = 0.00044,P < 0.001)。仅患高血压患者的血压控制率显著提高(比值比 = 1.00039,P < 0.001)。合并/未合并高血压的糖尿病患者的FPG控制率均显著提高(比值比 = 1.00013,P < 0.001;比值比 = 1.00020,P < 0.001)。与仅患高血压的患者相比,合并症患者的基线SBP和DBP较低,但最新SBP较高(系数 = -1.18872,P < 0.001;系数 = -1.16049,P < 0.001;系数 = 1.0634,P < 0.001)。合并症患者的基线血压和FPG控制率低于仅患一种疾病的患者,且在最新随访时差异更大(比值比 = 0.28086,P < 0.001;比值比 = 0.91012,P = 0.049;比值比 = 0.04020,P < 0.001;比值比 = 0.69465,P < 0.001)。

结论

血压和空腹血糖管理结果取得了进展。合并症患者在血压水平尤其是SBP水平以及SBP、DBP和FPG的控制率方面比仅患一种疾病的患者表现更差。未来研究应使用全国数据并纳入更多混杂因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de12/9707550/bf73a5d62487/RMHP-15-2221-g0001.jpg

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