900例中老年高血压患者服药情况及动态血压监测的调查

目的调查目前高血压患者的服药情况及其对血压曲线的影响。方法随机选择门诊及住院的高血压患者,详细询问其病史和所服药物,并对其服用现有降压药物的情况进行24h动态血压监测。结果 (1)900例高血压患者中72例(占8%)未服任何降压药;单药治疗268例中,服用短效药物者171例(占63.8%),服用中长效药物者97例(占36.2%);联合治疗的560例中短效联合用药401例(占71.6%),中长效联合药159例(占28.4%)。(2)服用中长效单药治疗者其杓型、非杓型、超杓型及清晨高血压比例与服用短效药物者比较,差异均有统计学意义(P<0.05)。(3)联合治疗中长效药物其杓型、非杓型、超杓型、清晨高血压比例与短效联合药物比较,差异均有统计学意义(P<0.05)。结论 (1)对于高血压患者应该尽量服用长效药物,并且采取联合治疗,以有效、平稳控制血压,并调整患者血压的昼夜节律;(2)上级医院的专科医师应尽量多地组织基层治疗单位医师进行"中国高血压防治指南"的培训,使高血压防治更加规范化。

The Situation of the Taking Medicine Compliance in 900 Case Older Hypertension Suffer and the Analysis of the Ambulatory Blood Pressure Monitoring

Objective To investigate the drugs treatment of hypertension patients currently and the influence of the blood curve.Methods Outpatients and patients in hospital were selected randomly.The medical record and the drugs were asked in detail and 24th ambulatory blood pressure was monitored according to the drugs at present.Results(1) The 72 cases in 900 hypertensive patients have not adopted any antihypertensive drugs.In 268 cases,171 patients take only one short-acting drugs and other 97 patients take long-acting drugs.In the combined treatment of 560 cases,401 cases adopted short-acting combined drugs and 159 cases were long-acting combined drugs.(2) There were significant difference in the proportion of dipping-Bp,non-dipping Bp,extreme-dipping Bp and morning hypertension between the long-acting drugs and short-acting drugs in the alone treatment.(3) There were significant difference in the proportion of dipping-Bp,non-dipping Bp,extreme-dipping Bp and morning hypertension between the long-acting drugs and short-acting drugs in the combined treatment.Conclusion(1) Patients with hypertension should try taking long-acting drugs,especially the combination of long-acting antihypertensive drugs can control blood pressure effectively and smoothly.Blood circadian rhythm should be adjusted to dipping-Bp.(2) Physicians at a higher level should organize the training as much as possible according to The Chinese Hypertension Prevention Giude.The cure of hypertension will be standardized gradually.