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西南地区住院高血压患者临床特征、治疗与控制状况及其影响因素
彭春梅,黄晓波,饶莉,刘剑雄,奚勇斌,张进,张廷杰,冉迅,胡蓉,佘强,曾伟,胡咏梅,刘雅,张阳
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(成都市第二人民医院心内科;四川大学华西医院心内科;重庆医科大学附属第二医院心内科;云南省第一人民医院心内科;成都市第一人民医院心内科;贵州省人民医院心内科;成都市疾病预防控制中心)
摘要:
【摘要】 目的 了解西南地区中心城市三甲医院心内科住院高血压患者临床特征、降压治疗状况、高血压控制率及其影响因素。方法 选取成都、贵阳、重庆、昆明的5家三级甲等医院为合作研究中心,于2011年8月~2012年2月在各医院心内科抽取符合纳入标准的住院患者为研究对象。收集研究对象的一般人口学资料,调查患者的心血管危险因素、靶器官损害及相关疾病情况、降压药物应用情况、血压控制状况,分析影响血压控制的因素。结果 40岁以上住院高血压患者共计2031例,平均年龄(594±103)岁。2级和3级高血压分别占421%、488%,主要心血管危险因素高脂血症、糖尿病、吸烟、肥胖的患病率均较高,除血压及年龄因素外,80%的患者至少有一个主要的心血管危险因素。高血压患者合并靶器官损害及相关疾病较为普遍。726%的2、3级高血压患者予以两种或两种以上降压药物治疗。降压药物使用最多的是钙通道阻滞剂(CCB)。所有联合降压方案,CCB 联合血管紧张素受体阻滞剂(ARB)是最常用的降压组合。出院时高血压控制率为545%。影响住院期间高血压治疗达标的主要危险因素为年龄、慢性肾功能不全、糖尿病、漏服降压药、高血压分级3级及肥胖。结论 西南地区三甲医院住院高血压患者合并主要心血管危险因素、靶器官损害及相关疾病均较为常见。住院高血压患者降压治疗基本规范,高血压控制率尚可。合理控制高血糖,适宜控制体重,改善肾功能不全患者肾功水平,提高服药依从性,对于提高住院高血压患者降压达标率可能有积极意义。
关键词:  高血压  心血管危险因素  降压  控制率
DOI:
基金项目:四川省卫计委科研课题(2011 1E+05 16)
Clinical features, status of antihypertensive treatment, and control of hypertension among hypertensive patients treated in Department of Cardiology of Tertiary Hospitals in Southwest China
PENG Chunmei,HUANG Xiaobo,RAO Li,LIU jianxiong,XI Yongbin,ZHANG Jin,ZHANG Tingjie,RAN Xun,HU Rong,SHE Qiang,ZENG Wei,HU Yongmei,LIU Ya,ZHANG Yang
(Department of Cardiology, Chengdu Second People’s Hospital;Department of Cardiology, West China Hospital, Sichuan University;Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University;Department of Cardiology, The First Hospital of Yunnan;Department of Cardiology, Chengdu First People’s Hospital;Department of Cardiology, The People Hospital of Guizhou;Chengdu Center for Disease Control and Prevention)
Abstract:
【Abstract】 Objective To survey the clinical features, status of antihypertensive treatment, and control of hypertension among hypertensive patients treated in department of cardiology of tertiary hospitals in central cities in Southwest China. Methods Five tertiary hospitals, two in Chengdu, and one each in Guiyang, Chongqing, and Kunming, were selected as the centers of study. Inpatients in department of cardiology from August 2011 to February 2012 who met the inclusion criteria were included in this study. Information regarding general demographics, cardiovascular disease (CVD) risk factors, target organ damage or associated diseases among hypertensive patients, antihypertensive treatment, and control rate of hypertension were collected and analyzed factors. Results The study consisted of 2,031 hypertensive inpatients aged 40 years and older [average(594 ± 103)years]. In the study, 421% of patients had stage 2 hypertension, and 488% had stage 3 hypertension. The prevalence of major CVD risk factors, including hyperlipidemia, diabetes, smoking, and obesity, was relatively high. Other than hypertension and old age,80% of patients had at least one major CVD risk factor. Target organ damage and associated diseases were common among the hypertensive patients. In total, 726% of the stage 2 and 3 hypertensive patients were treated with two or more antihypertensive drugs. Calcium channel blockers(CCB)were the most commonly used antihypertensive drug. CCB and angiotensin II receptor blockers (ARBs) were the most common type of combination antihypertensive therapy. The control of hypertension was 545% at the time of patient discharge. Major risk factors that affected BP control rates during hospitalization included age, chronic renal insufficiency, diabetes, missing antihypertensive drugs, stage 3 hypertension, and obesity. Conclusion In summary,most of the hypertensive inpatients had moderate to severe hypertension, which was commonly accompanied by major CVD risk factors, as well as target organ damage and associated diseases. Although the antihypertensive treatment of hypertensive inpatients was standardized, with acceptable BP control rates, there is room for improvements. Improvements in hyperglycemia control, weight control, and drug compliance, as well as improvements in the renal functions of patients with renal insufficiency, perhaps could markedly enhance BP control rate of hypertensive inpatients.
Key words:  Hypertension  Cardiovascular disease risk factor  Antihypertension  Control rate

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