Cardiovascular Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China.
Cardiovascular Department, The Second Hospital of Shanxi Medical University, Taiyuan, China.
J Clin Hypertens (Greenwich). 2024 Sep;26(9):1054-1062. doi: 10.1111/jch.14870. Epub 2024 Jul 16.
There are no nationwide surveys on antihypertensive drugs in China. In order to assess the current status of antihypertensive drug therapy in patients with hypertension and analyzed factors that may affect combination therapy, using convenience sampling, we recruited 305,624 patients with hypertension from the Chinese Cardiovascular Association Database-Hypertension Center between January 2019 and December 2021. Chi-squared test was performed to analyze the administered antihypertensive drug types and their combinations in different hospital settings. Logistic regression was used to assess the factors influencing combination therapy. We found around 33.1% of the participants had stage 2 and above hypertension, of which 67.9% were treated with combination therapy. In community or general hospitals, the most common monotherapy was calcium channel blockers (CCB), angiotensin-converting enzyme inhibitor/angiotensin II receptor inhibitor (ACEI/ARB) and diuretic were the main single-pill combinations (SPCs), and ACEI/ARB and CCB were the main free combination. From 2019 to 2021, the rates of combination therapy increased (58.8%-64.1%) with SPCs from 25.9% to 31.0% and free combination from 31.9% to 32.6%. Patients aged < 60 years, with stage 2 and above hypertension, with an education level of high school and above, visiting general hospitals, living in the eastern region of China, with hypertension risk factors and comorbidities, and without anxiety or depression were more likely to receive combination therapy (all P < .05). The combination therapy use rate increased yearly and the rate of SPCs rose obviously. Individual, hospital, and regional differences in patients with hypertension influenced combination therapy.
在中国，没有关于抗高血压药物的全国性调查。为了评估高血压患者抗高血压药物治疗的现状，并分析可能影响联合治疗的因素，我们采用便利抽样法，从 2019 年 1 月至 2021 年 12 月期间从中国心血管协会数据库-高血压中心招募了 305624 名高血压患者。采用卡方检验分析不同医院环境中使用的抗高血压药物类型及其组合。采用 logistic 回归评估影响联合治疗的因素。我们发现，大约 33.1%的参与者患有 2 期及以上高血压，其中 67.9%接受了联合治疗。在社区或综合医院，最常见的单一疗法是钙通道阻滞剂（CCB），血管紧张素转换酶抑制剂/血管紧张素 II 受体抑制剂（ACEI/ARB）和利尿剂是主要的单一药丸组合（SPC），而 ACEI/ARB 和 CCB 是主要的自由组合。从 2019 年到 2021 年，联合治疗的比例有所增加（58.8%-64.1%），SPC 从 25.9%增加到 31.0%，自由组合从 31.9%增加到 32.6%。年龄<60 岁、患有 2 期及以上高血压、受教育程度为高中及以上、就诊于综合医院、居住在中国东部地区、有高血压危险因素和合并症、无焦虑或抑郁的患者更有可能接受联合治疗（均 P<.05）。联合治疗使用率逐年增加，SPC 使用率明显上升。高血压患者在个体、医院和地区方面存在差异，影响联合治疗。
