北京地区心内科门诊患者高血压治疗情况横断面调查

Prevalence,treatment and control rate of hypertension in outpatients of Beijing area:a cross-sectional survey

目的 了解北京地区心内科门诊患者高血压的发生率、治疗情况及控制率。方法选取2014年中国高血压筛查公益项目(iSTATUS)研究中北京地区心内科门诊患者调查数据,总共纳入36家医院患者90 790例,记录患者血压、降压药物治疗情况、合并疾病、心血管病危险因素等项目。结果在所有心内科门诊患者中高血压发生率为81.7%(74 148/90 790),65 483例(88.3%)患者接受药物治疗,41 778例(59.1%)血压得到控制(<140/90mm Hg)。在降压药物选择上,钙拮抗剂使用率最高,为46.4%(30 384/65 483),血管紧张素受体拮抗剂为27.9%(18 270/65 483)。在所有应用降压药物治疗的患者中,32 700例(49.9%)采用单药治疗,25 966例(39.7%)采用两种药联合治疗,6817例(10.4%)采用≥3种降压药治疗。在单药治疗患者中,钙拮抗剂使用率仍然最高,达47.3%,不同药物治疗的控制率差别不大,只有利尿剂控制率较低(58.5%)。在使用两种降压药物联合治疗的患者中,钙拮抗剂和血管紧张素受体拮抗剂的联合方案使用最广泛(41.8%),并且达标率较高(69.4%)。其中钙拮抗剂/血管紧张素受体拮抗剂单片复方制剂的血压控制率最高达76.6%。结论北京地区心内科门诊患者中高血压发生率高,但治疗控制率较好,与广泛使用联合降压治疗或单片复方制剂有关。钙拮抗剂和血管紧张素受体拮抗剂是北京地区心内科门诊高血压患者最常使用的降压药物,同时也是最常用的联合降压治疗方案。

Objective To investigate the prevalence,medication and the control rate of hypertension in outpatients of Beijing. Methods A total of 90 790 patients from 36 hospitals in iSTATUS study were enrolled. Blood pressure and patients’ information were collected including cardiovascular risk factors,co-morbidities and anti-hypertensive medications,etc. Results The prevalence of hypertension in outpatients of Beijing was 81.7%（74 148/90 790）. Among those,65 483 patients（88.3%）received anti-hypertensive medications,and 41 778 patients（59.1%）achieved well blood pressure control（〈140/90 mm Hg）. Calcium channel blocker was the most common used,its use rate was 46.4%（30 384/65 483）. The next was angiotensin receptor blocker,its use rate was27.9%（18 270/65 483）. Among patients received anti-hypertensive medications,32 700（49.9%）patients received monotherapy,25 966（39.7%）patients received combined therapy with two drugs,and 6817 patients（10.4%）with three drugs and more. Calcium channel blocker was the most common choice of monotherapy,accounted for 47.3%. The control rates of different kinds of single anti-hypertensive medications were similar,diuretics had the lowest control rate（58.5%）. Calcium channel blocker plus angiotensin receptor blocker were the most common combination of two drugs,with the control rate of 69.4%. In addition,calcium channel blocker/angiotensin receptor blocker single-pill combination had the highest control rate（76.6%）. Conclusion The prevalence of hypertension was high in out patients of Beijing,well blood pressure control was achieved mainly by combined therapy including fixed-dose drugs. Calcium channel blocker and angiotensin receptor blocker were the most common anti-hypertensive medications,and also the most common combined therapy.