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[药物治疗对高血压社区控制的影响——对北京市东城区1000余例高血压患者的随访研究]

[The effect of medical treatment on hypertension community control--a follow-up study of more than one thousand hypertensives in East City Proper, Beijing].

作者信息

Ren X, Yan D, Huang B

机构信息

Institute of Epidemiology and Microbiology, CAPM, Beijing.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 1994 Jun;15(3):145-9.

PMID:7834689
Abstract

Hypertension exerts a great threat on human health. Although most of countries promote the management of hypertension in communities, the role of treatment of hypertension is still controversial, it directly influences the strategy of hypertension community control. This study was based on the survey of essential and borderline hypertension in Gu-lou District of East City Proper, Beijing in 1981, and the management of 1339 hypertensives in the follow-up from 1982 to 1985, and the mortality registration in the district by Disease Surveillance System. By observing the prognosis within one year among different treatment groups (nonusers, less than 9 months and more than 9 months within one year), 1289 patients were followed up for a total of 4283 person-years. Crude analyses, stratified and logistic analyses with multi-variables adjustment of age, sex, blood pressure, with or without end-organ damage, etc. could not find that treatments had obvious effects on the reduction of incidence and mortality of stroke, mortality of CVD and all-cause in hypertensives except severe cases. The stratified analyses dy smoking also showed that smoking had a disadvantageous effects for treated hypertensives. Based on our results, we suggest that health education should be a major part of hypertension management program in community; treatments of hypertension should consider the flexible situation of patients and may not be a priority in hypertension community control program.

摘要

高血压对人类健康构成巨大威胁。尽管大多数国家都在推动社区高血压管理,但高血压治疗的作用仍存在争议,这直接影响着高血压社区控制策略。本研究基于1981年对北京市东城区鼓楼地区原发性和临界高血压的调查、1982年至1985年对1339例高血压患者的随访管理以及该地区疾病监测系统的死亡登记。通过观察不同治疗组(未使用者、一年内用药少于9个月和多于9个月)一年内的预后情况,对1289例患者进行了总计4283人年的随访。进行粗分析、分层分析以及对年龄、性别、血压、有无靶器官损害等进行多变量调整的逻辑分析后发现,除重症患者外,治疗对高血压患者中风发病率和死亡率的降低、心血管疾病死亡率以及全因死亡率并无明显影响。按吸烟情况进行的分层分析还显示,吸烟对接受治疗的高血压患者有不利影响。基于我们的研究结果,我们建议健康教育应成为社区高血压管理项目的主要组成部分;高血压治疗应考虑患者的具体情况,在高血压社区控制项目中可能并非优先事项。

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