Nilsson P, Andersson D K, Andersson P E, Schwan A, Ostlind B, Malmborg R, Lithell H, Andersson O K
Health Sciences Centre, Lund University, Dalby, Sweden.
J Intern Med. 1993 Mar;233(3):239-45. doi: 10.1111/j.1365-2796.1993.tb00982.x.
Hypertensive patients still face a considerable risk of cardiovascular disease in spite of drug treatment in many studies. This may partly be explained by metabolic disturbances, both primarily linked to hypertension but also secondarily influenced by anti-hypertensive drugs themselves. In order to evaluate residual cardiovascular risk factors we investigated 1915 treated hypertensives (912 males, 1003 females) attending 128 health centres from all parts of Sweden. Mean blood pressure was 148/91 mmHg for males and 151/90 for females, but a substantial proportion of all patients were not well controlled, having a diastolic blood pressures > or = 100 mmHg (17% males, 12% females). Total cholesterol and HDL-cholesterol were 6.03 and 1.25 mmol l-1 for males, and 6.40 and 1.50 for females. The corresponding figures for serum triglycerides were 2.03 and 1.72 mmol l-1, respectively. In all, 38% of the hypertensives had hypercholesterolaemia (> or = 6.5 mmol l-1) and 27% hypertriglyceridaemia (> or = 2.3 mmol l-1). The lipid/lipoprotein findings may also be influenced by the various anti-hypertensive drugs used in Sweden. The prevalence of smoking and diabetes mellitus were 25% and 11% for men, and for women 24% and 9%. In conclusion, Swedish hypertensives show evidence of significant residual cardiovascular risk factors in spite of treatment. This may be of importance for future relative and absolute cardiovascular risk. It is time to re-evaluate the effectiveness of our management and care of hypertensive patients.
尽管在许多研究中药物治疗能控制血压，但高血压患者仍面临相当大的心血管疾病风险。这可能部分归因于代谢紊乱，其既主要与高血压相关，也会受到抗高血压药物本身的继发影响。为了评估残余心血管危险因素，我们调查了来自瑞典各地128个健康中心的1915例接受治疗的高血压患者（男性912例，女性1003例）。男性平均血压为148/91 mmHg，女性为151/90 mmHg，但所有患者中有很大一部分血压控制不佳，舒张压≥100 mmHg（男性17%，女性12%）。男性总胆固醇和高密度脂蛋白胆固醇分别为6.03和1.25 mmol/L，女性分别为6.40和1.50 mmol/L。血清甘油三酯的相应数值分别为2.03和1.72 mmol/L。总体而言，38%的高血压患者患有高胆固醇血症（≥6.5 mmol/L），27%患有高甘油三酯血症（≥2.3 mmol/L）。瑞典使用的各种抗高血压药物也可能影响血脂/脂蛋白的检测结果。男性吸烟和糖尿病的患病率分别为25%和11%，女性分别为24%和9%。总之，尽管接受了治疗，但瑞典高血压患者仍存在显著的残余心血管危险因素。这可能对未来心血管疾病的相对和绝对风险具有重要意义。是时候重新评估我们对高血压患者的管理和护理效果了。
