中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
1期
54-56,59
,共4页
鲍艳江%郭雪微%刘东云%刘素珀%任骏%张连波%宋志鑫%张彩红%高永莉%马丽娟%郭茂林%鲍双
鮑豔江%郭雪微%劉東雲%劉素珀%任駿%張連波%宋誌鑫%張綵紅%高永莉%馬麗娟%郭茂林%鮑雙
포염강%곽설미%류동운%류소박%임준%장련파%송지흠%장채홍%고영리%마려연%곽무림%포쌍
高血压病%降压药物%达标率%农村
高血壓病%降壓藥物%達標率%農村
고혈압병%강압약물%체표솔%농촌
Hypertension%Antihypertensive drugs%Control rate%Countryside
目的：了解北京农村地区老年高血压患者降压药物使用及高血压控制情况。方法对北京大兴区长子营地区1240例60岁以上正在治疗的高血压患者降压药物使用及血压控制情况进行调查。降压药分为三类：推荐制剂、传统制剂、中药制剂。推荐制剂：包括血管紧张素转换酶抑制剂（ACEI）、血管紧张素Ⅱ受体拮抗剂（ARB）、β受体阻滞剂（βRB）、钙通道阻滞剂（CCB）和噻嗪类利尿剂（HCTZ）；传统制剂：包括降压0号、复方降压片、复方利血平等；中药制剂：包括罗布麻片、珍菊降压片、牛黄降压丸等。降压药物使用后血压≤140/90 mmHg为血压达标。结果1240例调查对象中710例（57.2%）使用推荐制剂，499例（40.2%）使用传统制剂，9例（0.7%）使用中药制剂，22例（1.7%）使用推荐制剂+传统制剂；血压达标率分别为43.1%、40.7%、33.3%和54.5%；总体达标率为42.3%。使用推荐制剂患者中选用单种及两种或三种降压药联合治疗的患者分别占66.9%、31.0%和2.1%，血压达标率分别为34.1%、60.0%和80.0%。使用单种推荐制剂的患者中使用CCB、ACEI/ARB,βRB和HCTZ比例分别为62.1%、29.9%、6.3%和5.6%。使用两种推荐制剂联合治疗的患者中CCB+ACEI/ARB占83.2%，HCTZ+其他推荐制剂患者仅为2.3%。结论北京局部农村地区老年高血压治疗药物使用尚不够规范，推荐制剂使用不足60%；推荐制剂组达标率高于传统制剂组和中药制剂组。40%以上的患者使用传统制剂和中药制剂，有必要进一步探讨其降压效果和是否减少心脑血管疾病发生的循证医学证据。
目的：瞭解北京農村地區老年高血壓患者降壓藥物使用及高血壓控製情況。方法對北京大興區長子營地區1240例60歲以上正在治療的高血壓患者降壓藥物使用及血壓控製情況進行調查。降壓藥分為三類：推薦製劑、傳統製劑、中藥製劑。推薦製劑：包括血管緊張素轉換酶抑製劑（ACEI）、血管緊張素Ⅱ受體拮抗劑（ARB）、β受體阻滯劑（βRB）、鈣通道阻滯劑（CCB）和噻嗪類利尿劑（HCTZ）；傳統製劑：包括降壓0號、複方降壓片、複方利血平等；中藥製劑：包括囉佈痳片、珍菊降壓片、牛黃降壓汍等。降壓藥物使用後血壓≤140/90 mmHg為血壓達標。結果1240例調查對象中710例（57.2%）使用推薦製劑，499例（40.2%）使用傳統製劑，9例（0.7%）使用中藥製劑，22例（1.7%）使用推薦製劑+傳統製劑；血壓達標率分彆為43.1%、40.7%、33.3%和54.5%；總體達標率為42.3%。使用推薦製劑患者中選用單種及兩種或三種降壓藥聯閤治療的患者分彆佔66.9%、31.0%和2.1%，血壓達標率分彆為34.1%、60.0%和80.0%。使用單種推薦製劑的患者中使用CCB、ACEI/ARB,βRB和HCTZ比例分彆為62.1%、29.9%、6.3%和5.6%。使用兩種推薦製劑聯閤治療的患者中CCB+ACEI/ARB佔83.2%，HCTZ+其他推薦製劑患者僅為2.3%。結論北京跼部農村地區老年高血壓治療藥物使用尚不夠規範，推薦製劑使用不足60%；推薦製劑組達標率高于傳統製劑組和中藥製劑組。40%以上的患者使用傳統製劑和中藥製劑，有必要進一步探討其降壓效果和是否減少心腦血管疾病髮生的循證醫學證據。
목적：료해북경농촌지구노년고혈압환자강압약물사용급고혈압공제정황。방법대북경대흥구장자영지구1240례60세이상정재치료적고혈압환자강압약물사용급혈압공제정황진행조사。강압약분위삼류：추천제제、전통제제、중약제제。추천제제：포괄혈관긴장소전환매억제제（ACEI）、혈관긴장소Ⅱ수체길항제（ARB）、β수체조체제（βRB）、개통도조체제（CCB）화새진류이뇨제（HCTZ）；전통제제：포괄강압0호、복방강압편、복방리혈평등；중약제제：포괄라포마편、진국강압편、우황강압환등。강압약물사용후혈압≤140/90 mmHg위혈압체표。결과1240례조사대상중710례（57.2%）사용추천제제，499례（40.2%）사용전통제제，9례（0.7%）사용중약제제，22례（1.7%）사용추천제제+전통제제；혈압체표솔분별위43.1%、40.7%、33.3%화54.5%；총체체표솔위42.3%。사용추천제제환자중선용단충급량충혹삼충강압약연합치료적환자분별점66.9%、31.0%화2.1%，혈압체표솔분별위34.1%、60.0%화80.0%。사용단충추천제제적환자중사용CCB、ACEI/ARB,βRB화HCTZ비례분별위62.1%、29.9%、6.3%화5.6%。사용량충추천제제연합치료적환자중CCB+ACEI/ARB점83.2%，HCTZ+기타추천제제환자부위2.3%。결론북경국부농촌지구노년고혈압치료약물사용상불구규범，추천제제사용불족60%；추천제제조체표솔고우전통제제조화중약제제조。40%이상적환자사용전통제제화중약제제，유필요진일보탐토기강압효과화시부감소심뇌혈관질병발생적순증의학증거。
Objective To survey the antihypertensive drug administration and blood pressure (BP) control in elderly patients with hypertension in Beijing countryside. Methods The situation of antihypertensive drug administration and BP control were investigated in 1240 patients aged over 60 in Zhangziying area of Daxing District in Beijing. The antihypertensive drugs were divided into 3 types, including recommended drugs, traditional drugs and Chinese medicinal. The recommended drugs included ACEI, ARB,βRB, CCB and HCTZ, traditional drugs, Beijing antihypertension No. 0, compound antihypertensive tables and compound reserpine, and Chinese medicinal, Luobuma Pian, Zhenju Jiangya Pian and Niuhuang Jiangya Wan. After administrating antihypertensive drugs, BP≤140/90 mmHg was taken as controlled BP. Results Among 1240 cases, 710 (57.2%) took recommended drugs, 499 (40.2%), traditional drugs, 9 (0.7%), Chinese medicinal and 22 (1.7%), recommended drugs and traditional drugs. The BP control rate was, respectively, 43.1%, 40.7%, 33.3%and 54.5%, and the total control rate was 42.3%. Among the patients took recommended drugs, 66.9%took single drug, 31.0%, two kinds drugs and 2.1%, 3 kinds of drugs, and BP control rate was, respectively, 34.1%, 60.0%and 80.0%. In single recommended drug, the percentage of CCB, ACEI/ARB,βRB and HCTZ was, respectively, 62.1%, 29.9%, 6.3%and 5.6%. Among the patients took two kinds of recommended drug, 83.2% took CCB+ACEI/ARB and only 2.3%, HCTZ+other recommended drugs. Conclusion The administration of antihypertensive drugs is not normative enough and the percentage of patients took recommended drugs is not reached 60%in elderly patients with hypertension in Beijing countryside. BP control rate is higher in recommended drug group than that in traditional drug group and Chinese medicinal group. As over 40%of patients are taking traditional drugs and Chinese medicinal, it is necessary to discuss further the EBM evidences of their effects of decreasing BP and incidence of cardiovascular diseases.
