老年高血压患者服药后血压控制情况及其不良反应

Treatment effects and adverse reactions of antihypertensive drugs in elderly outpatients

目的:探讨门诊就诊的老年高血压患者服用降压药物后血压控制情况及其常见的不良反应。方法:采用问卷调查和体格检查相结合的方法,对在我院门诊就诊的955例高血压患者的服药情况及出现的不良反应进行统计分析。结果:被调查者使用较多的降压药物是硝苯地平控释片(伲福达)、硝苯地平片剂(心痛定)和美托洛尔(倍他乐克),分别占所有被调查患者的69.8%、30.8%和27.5%。其次是吲达帕胺(寿比山)、依那普利(怡那林)、特拉唑嗪(高特灵)、贝那普利(洛汀新)和卡托普利。日常血压收缩压控制理想者(<140mmHg)约占患者的50%,舒张压控制理想者多于收缩压控制理想者。服药后不良反应中,钙离子拮抗剂以踝部水肿、利尿剂以低血钾多见,ACEI类药物主要表现为干咳,β受体阻滞剂以心动过缓为主要不良反应,α受体阻滞剂特拉唑嗪的不良反应主要为直立性低血压。治疗依从性的调查还表明约半数高血压患者在服药过程中存在不正确现象。结论:门诊老年高血压患者治疗过程中不良反应较多,且总体血压控制良好率不高。

Objective: To investigate the situation of antihypertensive drugs' use and their adverse effects for elderly outpatients. Method: Information of antihypertensive drugs' use and the resulting adverse effects in 955 elderly cases with primary hypertension in outpatient department was collected by questionnaire visit and physical examination. Results: The most common drugs, which the patients would use to decrease blood pressure, were nifedipine delayed-release tablet(69.8%), nifedipine(30.8%) and metoprolol(27.5%), and then followed by indapamide, enalapril, terazosin, benazepril and captopril. Only nearly half of patients' blood pressure were under control in normal range (systolic pressure <140mmHg, dialectic pressure <90mmHg). The most common adverse effects were lower limb edema for calcium antagonists, hypokalemia for diuretics, cough for ACEI (angiotensin-converting enzyme inhibitors), bradycardia for βreceptor blockers and postural hypotension for αreceptor blockers. Conclusion: Antihypertensive drugs were not satisfactory for control of blood pressure and the adverse reactions were common in elderly outpatients.