社区医疗中优化降压治疗对心脑血管病发生率的影响

Effect of optimal blood pressure control on the incidence rate of cardio-cerebrovascular diseases in community

目的 评价优化降压治疗对心脑血管发生率的影响。方法 高血压患者 70例组成优化降压组 ,在非药物治疗的基础上 ,普遍服用氢氯噻嗪和缓释非洛地平 ,必要时加用培哚普利或氯沙坦 ,每 3月随访 1次。另 15 1例高血压病患者组成对照组 ,按惯例自行门诊治疗。全部患者观察 3年。结果 优化降压组血压逐渐降低 ,至 3月时血压已显著低于对照组 (139 6± 11 4 / 84 1± 7 8,15 8 4± 12 1/ 87 9± 8 4 ,P >0 0 0 1) ,且差异持续 3年。 3年间 ,优化降压组的脑卒中发生率显著低于对照组 (4 2 9% ,13 2 4 %P <0 0 5 ) ,两组心肌梗死的发生率无显著差异(1 4 3% ,P >0 0 5 )。结论 在社区医疗中实施优化降压治疗可使脑卒中发生率明显降低 6 7 6 %。

Objective: To evaluate the effect of optimal blood pressure control on the incidence rate of cardio cerebrovascular diseases Methods:The optimal blood pressure lowering group consisted of 70 hypertensive patients who were treated by non drug regimen and with Hydrochlorothiazide and Felodpine MR, together with Perindopril or Losarlan when necessary, and were interviewed once every 3 months The control group consisted of 151 hypertensive patients who received ordinary outpatient service by themselves All the patients were observed for 3 years Results: The blood pressure of the optimal treatment group were decreased gradually and significantly lower than that of the control group at the end of the third month (139 6±11 4/84 1±7 8,158 4±12 1/87 9±8 4 P<0 001) Such difference in blood pressure lasted for 3 years Within 3 years the incidence rate of stroke in the optimal treatment group was significantly lower than that in the control group (4 29%,13 24%,P<0 05) while the incidence rate of myocardial infarction of the two groups didn't show significant difference(1 43%,3 33%,P>0 05) Conclusion: In the community medical treatment, optimal blood pressure control can decrease the incidence rate of stroke