高龄高血压患者在我国专家推荐降压标准下的血压控制现状调查  

Current status of blood pressure control in elderly hypertensive patients under the antihypertensive standard recommended by Chinese experts

作　　者：贺琼逸 范兴满 马晨越 王猛 张婧[1] 张海涛[1] He Qiongyi;Fan Xingman;Ma Chenyue;Wang Meng;Zhang Jing;Zhang Haitao(Department of Cardiology,Air Force Medical Center of PLA,Fifth Clinical College of Anhui Medical University,Hefei 230032,Anhui Province,China)

机构地区：[1]安徽医科大学第五临床医学院,解放军空军特色医学中心心内科,合肥230032 [2]河北北方学院研究生院

出　　处：《中华老年心脑血管病杂志》2024年第1期34-37,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：军队保健专项课题(21BJZ07)。

摘　　要：目的分析我国高龄高血压住院患者在降压标准150/90 mm Hg(1 mm Hg=0.133 kPa)下的降压达标率、用药及并发症分布情况。方法选择解放军空军特色医学中心所有科室年龄≥80岁且被诊断为高血压的409例住院患者为研究对象,将409例患者分为强化降压组(106例,收缩压<130 mm Hg)、标准降压组(155例,收缩压130~149 mm Hg)和降压未达标组(148例,收缩压≥150 mm Hg),分析各组患者血压控制现状。结果以150/90 mm Hg为降压标准时,强化降压组占25.9%,标准降压组占37.9%,降压未达标组占36.2%,降压未达标组年龄>90岁比例显著低于强化降压组和标准降压组(4.1%vs 7.5%、12.3%,P<0.05)。标准降压组一联用药比例显著高于强化降压组(46.5%vs 32.1%),强化降压组二联用药比例显著高于标准降压组(35.8%vs 22.6%),差异有统计学意义(P<0.05)。强化降压组并发心脏损害和脑血管损害比例显著高于标准降压组(43.4%vs 21.9%,26.4%vs 14.8%),合并视网膜病变比例显著低于标准降压组(11.3%vs 23.9%),差异有统计学意义(P<0.05)。结论对于高龄高血压患者,以150/90 mm Hg为启动降压标准更具有科学性、实用性,强化降压反而增加了高龄高血压患者心脑血管损害。Objective To analyze the antihypertensive compliance rate,drug use and complication distribution among very old hypertensive inpatients under the antihypertensive standard of 150/90 mm Hg in our country(1 mm Hg=0.133 kPa).Methods A total of 409 hospitalized patients aged≥80 years and diagnosed with hypertension in all departments of Air Force Medical Center of PLA were enrolled,and according to their clinical outcomes,they were divided into intensive antihypertensive group(106 cases,SBP<130 mm Hg),standard antihypertensive group(155 cases,SBP 130-149 mm Hg)and non-standard blood pressure group(148 cases,SBP≥150 mm Hg).The status of blood pressure control was analyze in each group.Results When 150/90 mm Hg was used as the blood pressure standard,25.9%were in the intensive blood pressure group,37.9%were in the standard blood pressure group,36.2%were in the non-standard blood pressure group.The proportion of patients aged>90 years was significantly lower in the non-standard blood pressure group than the intensive antihypertensive group and the standard anti-hypertensive group(4.1%vs 7.5%and 12.3%,P<0.05).The ratio of single-drug therapy was significantly higher in the standard antihypertensive group than the intensive antihypertensive group(46.5%vs 32.1%,P<0.05),and that of dual combination therapy was obviously higher in the intensive antihypertensive group than the standard antihypertensive group(35.8%vs 22.6%,P<0.05).The proportions of heart damage and cerebrovascular damage were significantly higher(43.4%vs 21.9%,26.4%vs 14.8%),and the proportion of complicated retinopathy was notably lower(11.3%vs 23.9%)in the intensive antihypertensive group than the standard antihypertensive group(P<0.05).Conclusion For very old hypertensive patients in our country,it is more scientific and practical to use 150/90 mm Hg as the starting standard for blood pressure reduction.Intensified blood pressure reduction increases cardiovascular and cerebrovascular damages in them instead.

关 键 词：高血压 抗高血压药 降压标准 血压控制 中国专家 强化降压 

分 类 号：R544.1[医药卫生—心血管疾病]