门诊高血压患者合并临床疾病及降压药物治疗的现状  

The prevalence of comorbidities and pharmacologic management of hypertensive outpatients

作　　者：王薇[1] 赵冬[1] 刘军[1] 孙佳艺[1] 齐玥[1] 刘静[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京市心肺血管疾病研究所流行病研究室,北京100029

出　　处：《中华高血压杂志》2013年第9期838-842,共5页Chinese Journal of Hypertension

摘　　要：目的了解我国门诊高血压患者合并临床疾病及降压药物使用情况。方法由中华医学会心血管病学分会发起,采用多中心横断面调查,于2009-06-12,在全国22个省市46家医院开展门诊高血压患者调查。每家医院连续入选符合标准的原发高血压患者至少100例;每位入选患者进行问卷调查、体格检查和实验室检查。收集门诊高血压患者5206例的数据。结果门诊高血压患者中,肥胖占56.0%,血脂异常占61.5%,合并临床疾病占42.6%。门诊最常用的降压药物是钙拮抗剂占57.0%;其次为血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB);使用率最低的是利尿剂占8.3%。合并糖尿病的高血压患者使用ACEI或ARB者占51.3%。心肌梗死后最常用的降压药是ACEI或ARB占66.5%,其次是β受体阻滞剂占53.4%。合并心力衰竭、肾功能受损的高血压患者,ACEI或ARB使用率分别占67.0%和57.3%。结论我国门诊高血压患者合并临床疾病的比例高;门诊高血压患者最常用的降压药物是钙拮抗剂和ACEI或ARB,利尿剂使用率低。Objective To investigate the status quo of comorbid clinical diseases prevalence and pharmacologic man agement of hypertensive outpatients in China. Methods Multi-center cross-sectional study was adopted in this sur vey. From June to December in 2009, surveys of hypertensive patients were carried out in 46 hospitals from twenty two cities of China. At least 100 essential hypertensive outpatients were consecutively recruited from each partici pant hospital according to the consistent inclusion criteria. All subjects were investigated by questionnaires, physical examinations, and biochemical analyses. A total of 5206 hypertensive outpatients＇ data were included in final a nalysis. Results Of all hypertensive outpatients, 56.0 % of them showed obesity, 61.5 % cases suffered from dyslipidemia, and 42.6% patients had comorbid clinical diseases. The most commonly used antihypertensive therapy was calcium channel blocker which accounted for 57. 0%, followed by angiotensin-converting enzyme inhibitor （ACEI or angiotensin receptor blockers （ARB）. And the least frequently used was diuretics, occupying only 8.3%. 51. 3% of hypertensive patients with diabetes used ACEI or ARB. And the most commonly used antihy pertenswe therapy after myocardial infarction was ACEI or ARB （ 66.50%o ） , followed by β- blockers （ 53.4 % ）. In hypertensive patients complicated with heart failure or impaired renal function, the application of ACEI and ARB were 67.0% and 57.3% respectively. Conclusions The occurrence of comorbid clinical diseases is high among hy pertensive outpatients in China. As for its pharmacologic management, calcium channel blocker and ACEI, or ARB is most frequently used, while diuretics is the least.

关 键 词：高血压 伴随疾病 药物治疗 流行病学 

分 类 号：R544.1[医药卫生—心血管疾病]