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荷兰阿姆斯特丹非洲苏里南裔和加纳裔高血压移民的抗高血压药物类别处方与血压控制:HELIUS研究

Antihypertensive Medication Category Prescriptions and Blood Pressure Control in African Surinamese and Ghanaian Migrants with Hypertension in Amsterdam, The Netherlands: The HELIUS Study.

作者信息

van Apeldoorn Joshua A N, Jansen Luka, Hoevenaar-Blom Marieke P, Harskamp Ralf E, Galenkamp Henrike, van den Born Bert-Jan H, Agyemang Charles, Richard Edo, Moll van Charante Eric P

机构信息

Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Department of General Practice, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

High Blood Press Cardiovasc Prev. 2025 Jan;32(1):69-77. doi: 10.1007/s40292-024-00690-w. Epub 2024 Nov 2.

Abstract

West African (WA) migrants in Europe have higher hypertension rates than the host populations. For African migrants, guidelines recommend diuretics and/or calcium channel blockers (CCB) for primary cardiovascular disease prevention, but data on antihypertensive medication (AHM) prescription patterns or related hypertension control rates are lacking. We assessed AHM prescription patterns and its relation to hypertension control among hypertensive WA migrants in the Netherlands compared to the host population. Cross-sectional data from WA or Dutch origin participants from the HELIUS study were used. Participants with treated hypertension and without diabetes, cardiovascular disease, or microalbuminuria were selected. We used logistic and linear regression analyses to assess the association between AHM categories and hypertension control rates (systolic blood pressure (BP) ≤ 140 mmHg and diastolic BP ≤ 90 mmHg) and the systolic BP levels. We compared 999 WA participants and 314 Dutch participants. Hypertension control rates were lower in the WA origin compared to Dutch origin participants (44.3% versus 58.0%, p < 0.001). For WA participants, prescription rates for any AHM category were: CCB (54.8%), diuretics (18.5%) beta-blocking agents (27.3%) and renin-angiotensin system blockers (52.6%). Prescription rates were higher for CCB and similar for diuretics compared to the Dutch participants. Neither CCB nor diuretics were associated with better control rates. Compared to Dutch participants, West African participants had similar diuretic prescriptions but significantly higher prescriptions for CCB. However, neither medications was associated with better hypertension control. Future research should explore physician and patient factors to improve hypertension control.

摘要

在欧洲的西非移民患高血压的比例高于当地居民。对于非洲移民,指南推荐使用利尿剂和/或钙通道阻滞剂(CCB)来预防原发性心血管疾病,但缺乏关于抗高血压药物(AHM)处方模式或相关高血压控制率的数据。我们评估了荷兰高血压西非移民与当地居民相比的AHM处方模式及其与高血压控制的关系。使用了来自HELIUS研究的西非或荷兰裔参与者的横断面数据。选取了接受高血压治疗且无糖尿病、心血管疾病或微量白蛋白尿的参与者。我们使用逻辑回归和线性回归分析来评估AHM类别与高血压控制率(收缩压(BP)≤140 mmHg和舒张压BP≤90 mmHg)以及收缩压水平之间的关联。我们比较了999名西非参与者和314名荷兰参与者。与荷兰裔参与者相比,西非裔参与者的高血压控制率较低(44.3%对58.0%,p<0.001)。对于西非参与者,任何AHM类别的处方率分别为:CCB(54.8%)、利尿剂(18.5%)、β受体阻滞剂(27.3%)和肾素 - 血管紧张素系统阻滞剂(52.6%)。与荷兰参与者相比,CCB的处方率较高,利尿剂的处方率相似。CCB和利尿剂均与更好的控制率无关。与荷兰参与者相比,西非参与者的利尿剂处方相似,但CCB的处方明显更高。然而,这两种药物均与更好的高血压控制无关。未来的研究应探索医生和患者因素以改善高血压控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa6/11782289/456f46255aaf/40292_2024_690_Fig1_HTML.jpg

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