重庆地区部分老年高血压患者现况调查及多学科诊治方案建议

A cross-sectional study of elderly patients with hypertension in Chongqing and suggestions for multidisciplinary diagnosis and treatment regimen

目的:对重庆地区部分老年高血压患者进行现况调查,了解我市老年高血压患者患病情况、医疗情况和疾病管理情况。方法:采用描述性横断面调查研究,选取 2016 年 2 至 6 月在重庆医科大学附属第一医院老年科、心内科住院及青杠护养中心自理区入住的老年高血压患者共 497 例进行调查。结果:共收集有效问卷 497 例,血压达标率为 55.73%。单因素分析时,年龄段、血压分级、饮酒史和就诊频率在血压达标组和未达标组之间差异有统计学意义。健康生活方式各指标完成率均在 50%以上。高血压危险分层相关实验室检查基本项目及部分推荐项目阳性率高。仅 24 例调查对象(4.83%)为单纯高血压,473 例调查对象(95.17%)有伴发疾病,最高伴发 8 种疾病。联合降压的调查对象有 275 例(55.33%),服用降压药种类最多为 4 种。结论:老年高血压患者存在多病共存、多重用药、治疗困难等特点,综合性医院应为老年高血压患者开设多学科诊治门诊,全面评估患者并制定合理完善的治疗方案。

Objective:To investigate the current status of elderly patients with hypertension in Chongqing,China,and to understand the prevalence,medical treatment,and disease management of elderly patients with hypertension. Methods:A descriptive cross-sectional study was performed for 497 elderly patients with hypertension who were admitted to Department of Geriatrics,Department of Cardiology,and Qinggang Nursing Center in The First Affiliated Hospital of Chongqing Medical University from February to June,2016. Results:A total of 497 usable questionnaires were collected,and the control rate of blood pressure was 55.73%. The univariate analysis showed that there were significant differences in age,blood pressure,drinking history,and frequency of hospital visits between the controlled blood pressure group and the uncontrolled blood pressure group. The completion rates of healthy lifestyle indicators were above 50%. There were high positive rates of the basic items and some recommended items in the laboratory examination for risk classification of hypertension. Of all respondents,24(4.83%) had simple hypertension and 473(95.17%) had concomitant diseases, with the highest number of 8 concomitant diseases. Of all respondents,275(55.33%) were treated with more than one antihypertensive drug,with the highest number of 4 drugs. Conclusion:Elderly patients with hypertension are characterized by the coexistence of multiple diseases,multiple drug use,and difficulties in treatment. Comprehensive hospitals should set up a multidisciplinary diagnosis and treatment mode for elderly hypertensive patients,in order to provide comprehensive evaluations and reasonable treatment regimens.