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非裔美国人肾脏疾病与高血压试点研究中的预约就诊率、药丸计数及目标血压达成情况

Appointment attendance, pill counts, and achievement of goal blood pressure in the African American Study of Kidney Disease and Hypertension Pilot Study.

作者信息

Lee J Y, Greene P G, Douglas M, Grim C, Kirk K A, Kusek J W, Milligan S, Smith D E, Whelton P K

机构信息

NIDDK, NIH, Bethesda, MD 20892-6600, USA.

出版信息

Control Clin Trials. 1996 Aug;17(4 Suppl):34S-39S. doi: 10.1016/s0197-2456(97)82680-3.

Abstract

The African American Study of Kidney Disease and Hypertension (AASK) Pilot Study evaluated the feasibility of conducting a 7-year clinical trial to assess the effect of two levels of blood pressure control based on mean arterial pressure (MAP) (low goal < or = 92 mm Hg or usual goal of 102-107 mm Hg) and three antihypertensive drug regimens (atenolol, amlodipine, or enalapril) as initial therapy in slowing the decline of renal function in African Americans with clinically diagnosed hypertensive nephrosclerosis. Ninety-four African American men and women between 18 and 70 years of age were randomized and followed for an average of 4.6 months. On average participants attended 87.5% of the scheduled monthly follow-up visits and achieved an acceptable level of medication adherence (80%-100% of prescribed doses by pill count) at 65.4% of those visits Blood pressure levels within goal were observed in 17.5% and 25.6% of the participants in the low- and usual MAP goal groups, respectively. Neither attendance nor medication adherence by pill count was associated with attainment of goal blood pressure. Although AASK Pilot Study participants maintained excellent attendance, their pill counts were lower than previously reported among clinical trial participants and goal blood pressure levels were difficult to achieve during the short period of follow-up.

摘要

非裔美国人肾脏疾病与高血压研究(AASK)初步研究评估了开展一项为期7年的临床试验的可行性,该试验旨在评估基于平均动脉压(MAP)的两种血压控制水平(低目标值≤92毫米汞柱或通常目标值102 - 107毫米汞柱)以及三种抗高血压药物治疗方案(阿替洛尔、氨氯地平或依那普利)作为初始治疗,对临床诊断为高血压性肾硬化的非裔美国人肾功能下降减缓的影响。94名年龄在18至70岁之间的非裔美国男性和女性被随机分组,并平均随访4.6个月。平均而言,参与者参加了87.5%的预定每月随访就诊,并且在65.4%的就诊中达到了可接受的药物依从性水平(通过药丸计数达到规定剂量的80% - 100%)。在低MAP目标组和通常MAP目标组中,分别有17.5%和25.6%的参与者血压水平处于目标范围内。就诊率和通过药丸计数得出的药物依从性均与达到目标血压无关。尽管AASK初步研究的参与者保持了极高的就诊率,但他们的药丸计数低于先前临床试验参与者的报告水平,并且在短期随访期间难以达到目标血压水平。

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