门诊高血压患者血压控制及其影响因素的聚类分析  

Cluster analysis on the blood pressure control rate and related factors of hypertensive outpatients in China

作　　者：孙丽[1] 王继伟[1] 余金明[1] 

机构地区：[1]复旦大学公共卫生学院公共卫生安全教育部重点实验室,上海200032

出　　处：《中华心血管病杂志》2015年第1期62-67,共6页Chinese Journal of Cardiology

摘　　要：目的 探讨不同地区的高血压患者血压控制及其影响因素分布状况是否存在差异,为有效防治高血压提供依据.方法 2011年3至5月,在全国31个城市132家二级及以上医院进行横断面调查,每位医生连续登记诊治台的5例高血压患者为研究对象,共收集18岁及以上患者4 110例,其中随诊患者3 682例,对每位入选者进行问卷调查、体格检查.结果 高血压患者中合并冠心病的患病率最高,为37.4％（1 368/3 662）.最常用的降压药是钙离子通道阻滞剂（CCB）占51.3％（1 861/3 628）,其次为血管紧张素受体拮抗剂（ARB）占42.8％（1 550/3 622）.根据聚类过程及聚类图,并结合实际意义将城市分为3类.第Ⅱ类城市血压达标率最高（37.0％）,第Ⅰ类城市最低（9.1％）.3类城市中,第Ⅰ类城市体质指数[（25.7±0.6） kg/m^2]、腰围[（90.6±3.1） cm]最大,冠心病、脑卒中的患病率最高,分别为60.8％、19.0％.结论 不同地区的高血压患者血压控制及其影响因素分布状况存在差异.体形胖以及有合并症的患者患病率高,血压达标率低.CCB和ARB的使用率高的患者,血压达标率高.Objective To explore the blood pressure （BP） control rate and related factors in different parts of China.Methods This cross-sectional survey was performed between March and May 2011 in 132 tertiary or secondary hospitals from 31 cities across China.Five consecutive hypertensive patients consulted to individual physician in these hospitals were included and a total of 4 110 patients aged ≥ 18 years were included,and 3 682 patients finished the follow-up protocol.All objects underwent questionnaire survey and physical examination.Cities were divided into 3 categories.Results Among included hypertensive outpatients,the prevalence of coronary heart disease was the highest （37.4%,1 368/3 662） comorbidity.The most commonly used antihypertensive medication was calcium channel blocker （51.3%,1 861/3 628）.Blood control rate was the highest in city category [（37.0%） and the lowest in city category Ⅰ （9.1%）.Accordingly,body mass index （BMI,（25.7 ±0.6） kg/m^2） and waist circumference （（90.6 ± 3.1） cm） were the largest and the prevalence of coronary heart disease （60.8%） and stroke （19.0%） were the highest in hypertensive outpatients from city category Ⅰ.Conclusion Blood pressure control rate varies among various cities in China.High BMI and co-morbidities of coronary heart disease and stroke are related to poor blood pressure control rate.

关 键 词：高血压 聚类分析 

分 类 号：R544.1[医药卫生—心血管疾病]