CAJ | 학술논문

目的探寻高血压患者清晨血压控制的现状和药物治疗方法.方法收集2012年3至4月早晨7:00-10:00之间于心内科门诊就诊的高血压患者的血压资料共2187例.根据患者就诊时的实际用药情况将患者分为:未服药；单一用药[钙拮抗剂(CCB)、血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)和B受体阻滞剂]及联合用药组,比较各组血压未达标情况.结果血压未达标患者共1193例,占54.6％.其中用药比例最高的CCB,其未达标患者比率61.7％(295/478).单用CCB类药与ACEI、ARB和B受体阻滞剂类药物之间的血压达标情况差异无统计学意义.亚组分析氨氯地平、硝苯地平、非洛地平未达标率分别是46.3％ (63/136)、70.5％(55/78)和73.8％(31/42),其中氨氯地平组的血压未达标率与硝苯地平组和非洛地平组相比,OR值分别是0.36(95％ CI:0.20 ～0.65)和0.31(95％CI:0.14 ～0.66).结论当前三级医院就诊患者清晨血压的未达标率偏高,单用氨氯地平组患者的清晨血压达标率可能优于单用硝苯地平组和单用非洛地平组.
목적 탐심고혈압환자청신혈압공제적현상화약물치료방법.방법 수집2012년3지4월조신7:00-10:00지간우심내과문진취진적고혈압환자적혈압자료공2187례.근거환자취진시적실제용약정황장환자분위:미복약；단일용약[개길항제(CCB)、혈관긴장소전환매억제제(ACEI)、혈관긴장소수체길항제(ARB)화B수체조체제]급연합용약조,비교각조혈압미체표정황.결과 혈압미체표환자공1193례,점54.6％.기중용약비례최고적CCB,기미체표환자비솔61.7％(295/478).단용CCB류약여ACEI、ARB화B수체조체제류약물지간적혈압체표정황차이무통계학의의.아조분석안록지평、초분지평、비락지평미체표솔분별시46.3％ (63/136)、70.5％(55/78)화73.8％(31/42),기중안록지평조적혈압미체표솔여초분지평조화비락지평조상비,OR치분별시0.36(95％ CI:0.20 ～0.65)화0.31(95％CI:0.14 ～0.66).결론 당전삼급의원취진환자청신혈압적미체표솔편고,단용안록지평조환자적청신혈압체표솔가능우우단용초분지평조화단용비락지평조.
Objective To explore the current status of morning blood pressure and medication of hypertensive patients in Beijing.Methods This study included 2187 hypertensive patients who visited the ambulance of our cardiology department in the morning (7:00-10:00) from March 2012 to April 2012.Patients were divided into three groups:no antihypertensive agent group,single antihypertensive drug therapy group (include CCB,ARB,ACEI,β-blocker) and combined drug therapy group at least one month.Blood pressure control rate was compared among the groups.Results Target blood pressure was not reached in 1193 patients (54.6％),most patients took CCB and the target blood pressure was not reached in 61.7％ (295/478) patients taking CCB.There was no significant difference on target blood pressure uncontrolled rate among the four single drug subgroups (CCB,ARB,ACEI,β-blocker).The blood pressure uncontrolled rate was 46.3％ (63/136) for amlodipine,70.5％ (55/78) for nifedipine and 73.8％ (31/42)for felodipine.There OR of uncontrolled blood pressure rate was 0.36 (amlodipine vs.nifedipine,95％ CI:0.20-0.65) and 0.31％ (amlodipine vs.felodipine,95％ CI:0.14-0.66).Conclusion The morning blood pressure uncontrolled rate is high in hypertensive patients visiting Beijing tertiary hospitals.Amlodipine is possible superior to nifedipine and felodipine on morning blood pressure control in this patient cohort.