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2022 年 5 月意大利测量月:全国调查中固定剂量复方制剂、治疗依从性和医学惰性的焦点。

May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey.

机构信息

Department of Life, Health and Environmental Sciences, Internal Medicine unit, ESH Excellence Center, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.

ESH Excellence Center, University of Brescia, Spedali Riuniti di Brescia, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2024 May;31(3):309-320. doi: 10.1007/s40292-024-00642-4. Epub 2024 Jun 3.

Abstract

INTRODUCTION

Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side.

METHODS

During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures.

RESULTS

A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%).

CONCLUSIONS

This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.

摘要

简介

高血压是心血管疾病(CVD)的主要危险因素。值得注意的是,只有大约一半的高血压患者能够达到推荐的血压(BP)控制目标。在治疗过程中,BP 持续不受控制的主要原因是患者一方缺乏依从性,以及医生一方存在治疗惰性。

方法

在全球 BP 筛查活动“五月测量月”(MMM)(2022 年 5 月 1 日至 7 月 31 日)期间,意大利高血压学会认可了一项全国性、横断面、机会性研究,旨在提高人们对高血压相关健康问题的认识。研究对志愿者成年人(年龄≥18 岁)进行了问卷调查,内容包括人口统计学/临床特征以及高血压治疗中使用固定剂量单片制剂的问题。BP 的测量采用标准程序。

结果

共纳入 1612 名参与者(平均年龄 60.0±15.41 岁;44.7%为女性)。他们的平均 BP 为 128.5±18.1/77.1±10.4mmHg。约一半的参与者久坐不动,或超重/肥胖,或患有高血压。55.5%接受完整 BP 评估的个体患有未控制的高血压。大多数人没有服用固定剂量的降压药物组合,也没有定期在家测量 BP。自我报告的 BP 药物依从性在血压控制和未控制的个体之间相似(95%与 95.5%)。

结论

这项调查发现,在所检查的人群中,存在着显著的治疗惰性和患者在治疗过程及其监测中的参与度低的问题,这突出了预防活动的重要性,以确定高血压管理不满意的领域,提高人群对危险因素的认识,最终目的是降低心血管风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ba/11161440/848260a3b41d/40292_2024_642_Fig1_HTML.jpg

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