社区人群中高血压患者的用药情况分析

The status of the use of antihypertensive agents in hypertensive patients in the community

目的了解我国社区人群中高血压患者的用药情况。方法在我国华北、华南、华东、东北、西北、西南不同地区(4个城市、8个农村)抽取12组年龄35~64岁人群,每组要求1000人,调查人群的一般情况、患病及高血压用药情况等。降压药物根据活性成分分为钙拮抗剂、血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)、利尿剂、β受体阻滞剂、中枢作用药物、血管扩张药和其他(中草药等)。结果调查对象11 623人,共检出高血压患者3983例,服用降压药患者为1239例(31.1%)。除329例使用其他类(中草药等),69例具体药物不详外,单药治疗患者367例(43.6%),联合治疗患者474例(56.4%)。单药治疗中应用比例最高的药物为钙拮抗剂(53.4%),联合治疗中比例最高的二联用药为钙拮抗剂+β受体阻滞剂(7.4%)。不常规推荐用药方案有β受体阻滞剂+ARB和ACEI+β受体阻滞剂联用(占1.5%、1.3%)。高血压合并心血管病患者381例中,有160例服用降压药,单药治疗患者82例(51.2%),联合治疗患者78例(48.8%)。结论我国社区人群中高血压用药方案基本符合《中国高血压防治指南》的要求,但仍存在不常规推荐的用药方案,单药治疗中钙拮抗剂应用比例最高。

Objective To understand the current status of the use of antihypertensive drugs in Chinese hypertensive patients in the community. Methods Subjects aged 35 to 64 years old were sampled from the north, south, east, northeast, northwest and southwest oi China fincluding 4 urban areas and 8 rural areas）. There were 12 groups of subjects and 1000 subjects in each group. The subjects＂ general condition, medical history, information on the use of antihypertensive drugs and so on were collected through the questionnaire survey. According to active ingredi- ents, antihypertensive agents were divided into calcium antagonists, angiotensin-converting enzyme inhihitors （ACEI ）, angiotensin receptor blockers （ ARB）, diuretics, heta-adrenoceptor blockers, central antihypertensive drugs, vasodilator agents and others （Chinese herbal medicine, etc）. Results A total of 11 623 subjects were en- rolled in the study and 3983 subjects were diagnosed as hypertensive patients. Among 3983 hypertensive patients, 1239 patients were taking antihypertensive drugs {31.1% ）. a single drug, and 474 hypertensive patients （56.4%） were 367 hypertensive patients （43.6%） were treated with treated with two or more antihypertensive drugs at the same time. Calcium antagonist was the most frequently used at^tihypertensive drug in the patients receiving mono- therapy （accounting for 53.4%）, and the combination of calcium antagonist and beta-adrenoceptor blocker was the most frequently used two-drug regimen in the patients receiving combination therapy （accounting for 7.4%）. Among two-drug regimens, unconventional regimens included the combination of beta-adrenoceptor blocker and ARB, and the combination of ACEI and beta-adrenoceptor blocker （accounting for 1.5% and 1.3%, respectively）. Among 381 hypertensive patients with cardiovascular disease, 160 patients were taking antihypertensive drugs, and there were 82 patients receiving monotherapy （ 51.2% ） and 78 patients receiving combination therapy （ 48.8%）. Conclusion The regimens of antihypertensive agents in Chinese hypertensive patients in the community were basically in accordance with the Chinese guidelines for prevention and treatment of patients with hypertension, but there were still unconventional regimens. Calcium antagonist was the most frequently used antihypertensive drug in the patients receiving monotherapy.