高血压病使用降压药物的流行病学研究

Study on the Epidemiology of Antihypertensive Drugs in Patients with Hypertension

目的 探讨高血压住院和门诊患者降压药物的依从性及其相关因素。方法 回顾性调查 1995 - 10～ 2 0 0 1-10高血压病住院患者 716例和门诊随访患者 4 5 7例的降压药物的使用情况和药物副作用的发生情况 ;观察药物依从者和不依从者的血压水平变化。结果 高血压住院患者的心血管危险因素分层前几位依次为吸烟、脂质代谢紊乱和糖尿病。出院后 6 3.8%的患者来院门诊随访。住院期间的药物依从率为 5 7.4 % ,出院时出院带药的依从率 75 .3% ,门诊随访期间的药物依从性为 5 0 .5 %。药物不依从的原因包括 :药物副作用、血压控制不佳、经济原因等。门诊随访过程中 ,利尿剂的副作用明显增加。药物依从者血压控制佳 ,波动小 ;而不依从者血压控制不佳 ,波动大。结论 出院后对出院带药的依从性最佳 ,住院期间的药物依从性次之 。

Objective To study the compliance of antihypertensive drugs and its related factors in inpatients and outpatients with hypertension.Method Clinical data of 716 inpatients and 457 outpatients were reviewed to study the compliance of antihypertensive drugs and related factors as well as to investigate the utilization of anti hypertensive medicament,the incidence of the side effect of the uncompliant group.Results The main risk factors of the hypertensive patients were in the order as:smoking,disorder of lipometabolism and Diabetes mellitus.63.8% of the inpatients were followed up.The incidences of compliance were 57.4% in the inpatients,75.3% when being discharged,and 50.5% in the outpatients.The cause of uncompliance were as follows:side effect of the medication,failure to control BP,financial problems,etc.Data gathered during follow up period,it was found the side effect of the diuretics inproved palpably.Those compliers controlled their BP well,while little fluctuation of BP was observed.However,the uncompliers showed different pictures,and the range of fluctuation of BP was large.Conclusions The compliance of the medicament was best among the outpatients to the discharge order,and the compliance of the outpatients was the worst.