Wang Liping, Yan Jin, Wang Fenghua, Xue Peng, Li Zheng, Jiang Rong, Lu Min, Yang Ning, Wei Junli, Wei Maoti, Ma Zhimin
Endocrinology Department, the Affiliated Suzhou Hospital of Nanjing University Medical School, Jiangsu, People's Republic of China.
Lhasa Detachment of Armed Police Crops Lhasa, Tibet Autonomous Region, People's Republic of China.
Patient Prefer Adherence. 2024 Dec 9;18:2519-2528. doi: 10.2147/PPA.S475936. eCollection 2024.
Medicine is critical for blood-pressure control in patients with type 2 diabetes mellitus (T2DM), for evaluation of treatment patterns and effects would offer baselines for future health services.
A cross-sectional study was conducted from August 2018 to January 2021 in the urban-rural fringe zone of Suzhou City, Jiangsu Province, China. Blood pressure and antihypertensive medication use were collected from T2DM patients combined with hypertension (HTN). Using systolic blood pressure (SBP) and diastolic blood pressure (DBP) <140/85 mmHg as HTN controls, medicine usage patterns were analyzed.
Among the 931 T2DM patients with HTN, 333 (37.0%, 95% : 33.8%-40.2%) had HTN controlled with SBP and DBP of <140/85 mmHg. Partial following the medicine recommendations for HTN control were observed in this zone, and calcium channel blocker (CCB), angiotensin II receptor blocker (ARB), diuretics and β-receptor blocker (Βeta-blocker) were the most frequently used ones, especially for CCB and ARB, which accounted for 67% (625/931) and 55% (509/931), respectively. For combination usage, complete adherence to the recommendation was observed, ie, ARB + CCB and ARB + diuretics were listed as the top two, accounting 30% (282/931) and 16% (153/931), respectively. Combination therapies had HTN control rates ranging from 31.1% to 39.1%, lower than those of monotherapy (>40%). In monotherapies, CCB had control rate of 41.2% (115/279, 95% 35.4%-47.2%), higher than combination (31.9%, 105/329, 95% 26.9%-37.3%), as well as ARB; the single reagent had control rate of 42.0% (95% 33.7%-50.7%), higher than combination (32.2%, 95% 27.4%-37.3%).
More than 60% of T2DM patients had blood-pressures above the target level and the pattern of medications for HTN control in T2DM patients followed the recommendation of the authorities; however, the effects were not as expected, and more antihypertensive medicines or combinations would not raise the HTN control rate.
药物治疗对于2型糖尿病(T2DM)患者的血压控制至关重要,评估治疗模式和效果可为未来的医疗服务提供基线数据。
2018年8月至2021年1月在中国江苏省苏州市城乡结合部开展了一项横断面研究。收集T2DM合并高血压(HTN)患者的血压和降压药物使用情况。以收缩压(SBP)和舒张压(DBP)<140/85 mmHg作为HTN控制标准,分析药物使用模式。
在931例T2DM合并HTN患者中,333例(37.0%,95%:33.8%-40.2%)的SBP和DBP控制在<140/85 mmHg。该地区部分患者遵循了HTN控制的药物治疗建议,钙通道阻滞剂(CCB)、血管紧张素II受体阻滞剂(ARB)、利尿剂和β受体阻滞剂是最常用的药物,尤其是CCB和ARB,分别占67%(625/931)和55%(509/931)。对于联合用药,完全遵循建议,即ARB+CCB和ARB+利尿剂位列前两位,分别占30%(282/931)和16%(153/931)。联合治疗的HTN控制率在31.1%至39.1%之间,低于单药治疗(>40%)。在单药治疗中,CCB的控制率为41.2%(115/279,95%:35.4%-47.2%),高于联合治疗(31.9%,105/329,95%:26.9%-37.3%),ARB也是如此;单一药物的控制率为42.0%(95%:33.7%-50.7%),高于联合治疗(32.2%),95%:27.4%-37.3%)。
超过60%的T2DM患者血压高于目标水平,T2DM患者HTN控制的用药模式遵循了权威建议;然而,效果未达预期,更多的降压药物或联合用药并不能提高HTN控制率。