中国高血压最佳治疗情况调查难治性高血压亚组分析

Refractory hypertension subgroup analysis of hypertension optimal treatment study in China

目的探讨中国高血压最佳治疗情况调查(HOT-CHINA)研究中难治性高血压患者的比例和特征。方法对HOT-CHINA研究(2001-04-2002-02)中入选患者(n=54590)治疗情况进行再分析。结果 HOT-CHINA研究人群中难治性高血压占1.9%。与非难治性高血压相比,难治性高血压患者男性多见(65.6%比60.2%),年龄较小[(59.5±13.0)比(61.8±12.3)岁],体质量指数较高[(24.8±3.5)比(24.0±3.4)kg/m2],病程长,空腹血糖、总胆固醇、三酰甘油水平高[分别为(6.60±2.69)比(5.99±2.12)、(5.67±1.63)比(5.32±1.24)、(2.15±1.32)比(1.96±1.09)mmol/L],3级高血压多见(71.1%比27.2%)。代谢综合征、糖尿病、心肌梗死、脑卒中患病率均高于非难治性高血压患者(均P<0.01)。结论难治性高血压多合并有其他危险因素或临床情况,难治性高血压患者要尽早联合用药,控制血压达标。

Objective To investigate and analyze the prevalence and clinical characteristics of patients with refractory hypertension in hypertension optimal treatment study in China（HOT-China）.Methods HOT-China study was carried out from Apr.2001 to Feb.2002.It was a registration study in which 54 590 hypertensives were enrolled in China's Mainland.The major results of the study have been published earlier.This post-hoc analysis aimed to identify the clinical characteristics of patients with refractory hypertension based on the database of the study.Results The prevalence of refractory hypertension was 1.9% in this group of subjects.Compared with those non-refractory hypertensives,there were more male subjects（65.6% vs 60.2%）,younger subjects [（59.5±13.0） vs（61.8±12.3）years-old],higher body mass index [（24.8±3.5） vs（24.0±3.4） kg/m2],longer course of disease,higher plasma fasting blood glucose,higher total cholesterol,higher triglyceride [（6.60±2.69） vs（5.99±2.12）,（5.67±1.63） vs（5.32±1.24）,（2.15±1.32） vs（1.96±1.09）mmol/L,respectively] and more patients with grade 3 hypertension（71.1% vs 27.2%） in refractory hypertensives.There were also more subjects complicated with metabolic syndrome,diabetes,myocardial infarction and stroke（P0.01）.Conclusion Refractory hypertensive patients are always complicated with multiple risk factors or clinical conditions.Early combination treatment is needed to reach the target blood pressure.