老年高血压患者清晨血压控制现状调查分析

Morning blood pressure control status investigation in hypertensive patients

目的了解65岁以上老年人清晨血压控制现状及用药情况。方法对来医院心内科就诊的高血压患者按照自愿原则给予测量2次血压,记录平均值,同时记录患者姓名、性别、年龄、收缩压、舒张压、是否服用降压药、服用降压药物名称等,按年龄分为老年组(≥65岁)636例,对照组(45≤Y<65岁)507例。结果老年组平均年龄(70.81±4.81)岁,清晨平均收缩压(systolic blood pressure,SBP)(143.64±15.87)mm Hg,清晨平均舒张压(diastolic blood pressure,DBP)(72.17±10.66)mm Hg,老年组高血压治疗率83.81%,血压达标率55.34%,其治疗率和达标率均高于中年组的78.30%和43.39%;老年组单药治疗率61.01%,达标率59.02%,两药联合治疗率19.65%,达标率69.05%,三药及三药以上联合治疗率2.04%,达标率45.15%,单药治疗中用药比例排序分别为钙离子拮抗剂(calcium channel blockers,CCB)(58.24%)>血管紧张素受体阻滞剂(angiotension receptor blocker,ARB)(30.15%)>β-受体阻断剂(8.25%)>血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors,ACEI)(2.84%)>利尿剂(0.26%),联合用药ARB+CCB(42.76%)比例最大,其次为CCB+β-受体阻断剂(13.38%)。结论 65岁以上老年人的清晨血压控制好于中年人,但仍需要进一步提高血压的治疗率、达标率及改善用药合理性。

Objective The alm of this study is to understand early morning blood pressure control status and medica-tion about hypertensive patients over 65 years old. Method Hypertensive patients who came to cardiology department were measured blood pressure twice in accordance with the voluntary principle and recorded average value,at the same time they were recorded name,sex,age,systolic pressure,diastolic pressure,whether the use of antihypertensive drugs,antihypertensive drug name. According to the age hypertensive patients were divided into the elderly group（≥65 years old） 636 patients and the control group （45~64） 507 patients. Result The elderly group had mean age of （70. 81±4. 81）years, average SBP （143. 64±15. 87）mmHg,average DBP （72. 17±10. 66）mmHg in the morning, the elderly group of hypertension treatment rate reached 83. 81%,the control rate of blood pressure was 55. 34%, the hypertension treatment rate and control rate was higher than the middle-aged group（treatment rate of 78. 30%, control rate of 43. 39%）. The elderly group had single-drug treatment rate of 61. 01%, control rate of 59. 02%,two-drugs combination therapy rate of 19. 65%,control rate of 69. 05%,more than three and three-drugs combination treatment rate of 2. 04%, control rate of 45. 15%. Medicine proportion monotherapy in elderly group was CCB （58. 24%）〉ARB（30. 15%）〉β-B （8. 25%）〉ACEI（2. 84%）〉D （0. 26%）,the largest proportion of two drugs combined medication was CCB＋ARB （42. 76%）, followed by CCB＋β-B （13. 38%）. Conclusion The eldly hyper-tensive patients（≥65 years old） had better morning blood pressure control than the middle-aged hypertensive pa-tients,but still need to further improve the treatment rate,blood pressure reatment rate and improve the rationality of antihypertensive medication.