门诊高血压患者血糖异常及代谢危险因素控制现状分析  

Analysis of blood glucose abnormalities and metabolic risk factor control in outpatient hypertensive patients

作　　者：邓利群[1] 林运[2] 张金鑫 王丽君[1] 蔡瑾[1] 李亚冬[1] 陶娟[2] 杨永红[2] DENG Liqun;LIN Yun;ZHANG Jinxin;WANG Lijun;CAI Jin;LI Yadong;TAO Juan;YANG Yonghong(Department of General Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

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全科医疗科,100029 [2]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心内科,100029

出　　处：《心肺血管病杂志》2025年第2期148-153,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：2024年首都卫生发展全科医学与社区卫生科研专项立项项目(2024-2Y-009)。

摘　　要：目的:分析门诊就诊的年龄35~64岁高血压患者,血糖异常及动脉粥样硬化性心血管疾病危险因素控制水平。方法:选取2022年1月至2024年1月,于首都医科大学附属北京安贞医院全科门诊连续纳入35~64岁高血压患者。收集其基本信息、既往病史、行为习惯及生化检查等信息。结果:共纳入研究对象3028例,平均年龄(54.4±6.0)岁,男性983例(32.5%)。中位高血压病程5年。血压分别以<140/90mm Hg(1mm Hg=0.133k Pa)及<130/80mm Hg为目标,血压控制率分别为53.4%和25.4%。患者自报糖尿病716例(23.6%),92例(3.0%)为可疑糖尿病患者,165例(5.4%)为糖尿病前期。以糖尿病病史及FPG≥7.0mmol/L为糖尿病患病标准,糖尿病患病率为26.7%(808/3028),11.4%(92/808)患者不知晓自己患有糖尿病。自报糖尿病患者钠-葡萄糖协同转运蛋白2抑制剂/胰高血糖素样肽-1受体激动剂应用率为15.1%,67.3%FPG<7.0mmol/L,他汀类药物应用率为30.0%,28.3%LDL-C<2.6mmol/L。结论:门诊中青年高血压患者约30%伴有糖代谢异常;有明确心血管获益证据的新型降糖药物及他汀类药物在自报糖尿病患者中应用不足;自报糖尿病患者血压、血脂达标率低。Objective:This study aims to assess the prevalence of blood glucose abnormalities and the control of atherosclerotic cardiovascular disease risk factors among hypertensive patients aged 35-64 years.Methods:We conducted a cross-sectional study from January 2022 to January 2024,enrolling hypertensive patients aged 35-64 at the General Outpatient Department of Beijing Anzhen Hospital,Capital Medical University.We collected data on demographic information,medical history,lifestyle habits,and biochemical test results.Results:A total of 3028 patients were included,with an average age of(54.4±6.0)years,of which 983(32.5%)were male.The median duration of hypertension was 5 years.Blood pressure targets were set at<140/90 mmHg(1mmHg=0.133kPa)and<130/80 mmHg,achieving control rates of 53.4%and 25.4%,respectively.Among the participants,716 reported having diabetes(23.6%),92 were classified as suspected diabetes(3.0%),and 165 were identified as prediabetic(5.4%).Using a history of diabetes and fasting plasma glucose(FPG)≥7.0 mmol/L as diagnostic criteria,the prevalence of diabetes was 26.7%(808/3028),with 11.4%(92/808)unaware of their condition.Among those self-reporting diabetes,the usage of SGLT-2 inhibitors or GLP-1 receptor agonists was 15.1%,while statin use was at 30.0%.Additionally,67.3%of self-reported diabetes patients had an FPG<7.0 mmol/L,and 28.3%had LDL-C<2.6 mmol/L.Conclusions:Approximately one-third of young and middle-aged hypertensive patients in outpatient settings exhibit glucose metabolism abnormalities.There is a notable underutilization of new antidiabetic medications and statins among self-reported diabetes patients who could benefit from cardiovascular protection.Additionally,the rates of achieving blood pressure and lipid control are low.

关 键 词：高血压 糖尿病 危险分层 降糖治疗 

分 类 号：R54[医药卫生—心血管疾病]