| 张丹薇,宋莉娟,李艳,宋佳丽,刘志洁,杨静玮,郑昕,张海波.我国西南地区高血压患者降压药物应用现状[J].Chinese journal of Epidemiology,2020,41(4):520-525 |
| 我国西南地区高血压患者降压药物应用现状 |
| Status on the use of anti-hypertensive drugs in the southwest areas of China |
| Received:June 27, 2019 |
| DOI：10.3760/cma.j.cn112338-20190627-00472 |
| KeyWord: 高血压 降压药物 联合用药 西南地区 |
| English Key Word: Hypertension Anti-hypertensive drug Drug combination therapy Southwest China |
| FundProject:国家重点研发计划（2018YFC1311205，2018YFC1312401，2018YFC1312404）；中国医学科学院医学与健康科技创新工程（2016-I2M-1-006）；国家卫生健康委员会重大公共卫生服务项目；国家科技重大专项（2018ZX09201012） |
| Author Name | Affiliation | E-mail | | Zhang Danwei | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Song Lijuan | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Li Yan | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Song Jiali | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Liu Zhijie | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Yang Jingwei | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Zheng Xin | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | | | Zhang Haibo | National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China | haibo.zhang@fwoxford.org |
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| Abstract: |
| 目的 了解我国西南地区高血压患者的降压药物应用现状。方法 研究基于 "心血管病高危人群早期筛查与综合干预项目",自2016年1月至2018年11月,采用方便抽样,对我国西南地区35~75岁成年人进行调查。研究收集调查对象的基本信息和心血管健康资料,检出高血压患者,并收集患者服用降压药物的名称、服药剂量和频率。分析不同特征亚组高血压患者的降压药物使用情况和个体影响因素,常用药物类型和联合用药组合模式。结果 共394 957名研究对象纳入分析。高血压患者159 014名,年龄为(58.8±9.5)岁,男性占40.2%,29.8%的患者接受了降压药物治疗。30 445名患者上报了具体用药信息,其中22.5%接受了联合用药治疗,在不同年龄、性别、血压水平及心脑血管病史组别中联合用药比例基本一致。多因素logistic回归分析显示,既往发生过心脑血管事件、肥胖、糖尿病的患者更可能接受联合用药治疗,而家庭年收入低、文化程度低的患者联合用药的可能性较低。单药治疗以钙拮抗剂为主(58.6%),联合用药以使用传统复方制剂最常见(31.4%),其次为血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂联合钙拮抗剂(22.4%);冠心病患者的联合用药以血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂联合β受体阻滞剂为主。结论 我国西南地区高血压患者的药物治疗率低,降压药物的使用仍然存在不规范之处,联合用药率亟待提高。 |
| English Abstract: |
| Objective To understand the current status of anti-hypertensive drug use in patients with hypertension in the Southwest areas of China. Methods Based on the Program of Screening and Intervention Subjects with High Risk Cardiovascular Diseases, this study presented information on adults aged 35-75 in Southwest China by convenient sampling method, from January 2016 to November 2018. Basic information and cardiovascular related data were collected. Data on hypertensive patients were recorded, including names, doses and frequency of anti-hypertensive drugs they used. Information on the use of anti-hypertensive drugs among different hypertension subgroups, potential related characteristics, types and combination patterns of drugs, etc., were analyzed. Results A total of 394 957 subjects were included in the study, with 159 014 identified as being hypertensive[mean age (58.8±9.5) years, 40.2% male]. 29.8% of them ever received antihypertensive drugs. A total of 30 445 of the patients reported detailed information of the drugs they ever used and 22.5% of them received therapy of combined drugs. Rates of using combination therapy were consistent among subgroups with different age, gender, blood pressure level and history of cardiovascular and cerebrovascular diseases. Results from the multivariate logistic regression analysis showed that patients with previous cardiovascular and cerebrovascular events, obesity or diabetes were more likely to have received combined therapy, while patients with less education or lower income were in the opposite. Calcium antagonists (58.6%) were the main drugs being used in single drug therapy, while traditional fixed-dose combination drugs (31.4%) were the most common ones in the drug-combination therapy, followed by angiotensin converting enzyme inhibitor/angiotensin receptor blocker combined with calcium antagonists (22.4%). Angiotensin converting enzyme inhibitor/angiotensin receptor blocker combined with beta blocker was the main drug used in patients with coronary heart disease. Conclusions Treatment programs using the antihypertensive drugs for hypertensive patients in Southwest China needs to be improved, since the irrational use of antihypertensive drugs still exists. However, we would encourage the use of combination therapy for hypertensive patients. |
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