意大利高血压的控制：“全科医疗中抗高血压治疗研究（STAP）”的结果。参与STAP研究的医生。

Control of hypertension in Italy: results of the "Study on Antihypertensive Treatment in General Practice (STAP)". Physicians Taking Part in STAP.

作者信息

Avanzini F, Alli C, Colombo P, Corsetti A, Colombo F, Tognoni G

机构信息

Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research, Milano.

出版信息

G Ital Cardiol. 1998 Jul;28(7):760-6.

PMID:9773300

Abstract

BACKGROUND

Various epidemiological surveys from different countries have documented the unsatisfactory control of arterial hypertension. The aim of this study was to assess the current status of treatment and control of hypertension in Italy.

METHODS

A random sample of general practitioners (GP) working in several Aziende Sanitarie Locali (Local health offices-ASL) throughout Italy were invited to take part in the study. Each doctor had to recruit a random sample of 15-20 hypertensive patients receiving antihypertensive drugs among those attending his/her office for any reason. A standard medical history, specifically oriented to hypertension and its pharmacological treatment, was taken for each patient. Three blood pressure (BP) measurements were made, with the patient seated for at least 5 minutes, using an accurate automatic device (A&D UA-732), and the mean was taken as each patient's BP.

RESULTS

A total of 73 GPs (17% of the invited sample), working in 14 Italian ASL (six in the north of the country, four in the center and four in the south and islands), agreed to participate in the study. They recruited an average of 17 patients each, for a total of 1204 hypertensive subjects (663 women and 541 men) 633 of whom were 65 years old or more, mean age 64 +/- 11 years, range 25-94 years. More than half (56%) had been taking antihypertensive drugs for at least five years; 42% were taking one drug, 40% two, 16% three and 2% four drugs. Respectively, 63% and 23% had systolic BP (SBP) > or = 140 and > or = 160 mmHg; 28% and 14% had diastolic BP (DBP) > or = 90 and 95 mmHg. In 71%, BP was < 160/95 mmHg, but only 33% had BP lower than 140/90 mmHg. BP control was similar in males and females, but worse in the elderly. Nine percent of patients complained of symptomatic side effects, usually mild. Only 8% admitted to poor compliance with the antihypertensive therapy, and their BP was significantly less well controlled.

CONCLUSIONS

Control of BP in patients receiving antihypertensive drugs is still far from optimal in Italy, just as in other countries. This situation seems more related to the fact that doctors do not tackle the problem aggressively, than to the patients' degree of compliance with therapy.

摘要

背景

来自不同国家的各种流行病学调查表明，动脉高血压的控制情况并不理想。本研究的目的是评估意大利高血压治疗与控制的现状。

方法

邀请在意大利各地几个地方卫生办公室（ASL）工作的全科医生（GP）随机样本参与研究。每位医生必须从因任何原因到其办公室就诊的患者中，随机抽取15 - 20名正在接受抗高血压药物治疗的高血压患者。为每位患者记录一份专门针对高血压及其药物治疗的标准病史。使用精确的自动设备（A&D UA - 732），让患者至少静坐5分钟后测量三次血压（BP），并取平均值作为每位患者的血压值。

结果

共有73名全科医生（占受邀样本的17%），在意大利14个ASL工作（该国北部6个，中部4个，南部和岛屿4个），同意参与研究。他们平均每人招募17名患者，共1204名高血压患者（663名女性和541名男性），其中633人年龄在65岁及以上，平均年龄64±11岁，年龄范围25 - 94岁。超过一半（56%）的患者服用抗高血压药物至少五年；42%的患者服用一种药物，40%服用两种，16%服用三种，2%服用四种药物。收缩压（SBP）≥140和≥160 mmHg的患者分别占63%和23%；舒张压（DBP）≥90和95 mmHg的患者分别占28%和14%。71%的患者血压<160/95 mmHg，但只有33%的患者血压低于140/90 mmHg。男性和女性的血压控制情况相似，但老年人的情况较差。9%的患者抱怨有症状性副作用，通常较轻。只有8%的患者承认抗高血压治疗依从性差，且他们的血压控制明显较差。