高血压患者收缩压控制率

目的 了解目前接受药物治疗的高血压患者收缩压达标率，医师对收缩压达标的认识及临床高血压用药情况。方法 采用调查问卷进行横断面调查，内容包括医师(2291人)和患者(8952人)两部分。医师填写患者收缩压达标的比例，干预收缩压最有效的降压药物。患者部分也由医师填写，包括患者的高血压及相关病史，家族史等，检查结果，治疗情况。结果 患者的收缩压达标率57％，而主观认为达标率大于50％的医生约占30％。经过高血压药物治疗，患者的收缩压幅度下降。随年龄、血压水平和危险分层的增加，收缩压降压幅度也相应增加，但是收缩压的达标率相对较低。心肌梗死、心力衰竭和脑卒中患者的收缩压降压幅度较大，控制率也较高。而糖尿病患者，降压幅度较小，控制率也较低。联合用药的患者降压幅度高于单一用药。收缩压下降的同时舒张压也相应下降，血压水平和危险分层高的患者舒张压下降幅度较大。患者平时使用最多的和医师主观上认为的最有效的降压药物都是钙拮抗剂。结论高血压患者经治疗后收缩压下降，高危患者的治疗需要高度重视，且开始治疗即可联合用药。临床高血压用药以钙拮抗剂为主。

The Investigation of the Systolic Blood Pressure Control Rate in Hypertensive Patients

ObjectiveTo study the SBP control rate of treated hypertension patients and the understanding rate of the physicians on the SBP control situation as well as the trend of the usage of antihypertensive medications.MethodsA survey of SBP questionnaire was conducted in a cohort of physician (n=2 291) and patients(n=8 952).The questionnaire included clinical data, antihypertensive medications and rate of goal SBP obtained. ResultsThe goal rate of SBP was achieved in 57% of the patients.The lowering magnitude of SBP was increased with patient's age, baseline SBP, concomitant diseases and the amounts of risk factors.The extent of SBP lowering was greater in patients with myocardial infarction, heart failure and stroke while it was much less in the patients with diabetes.Antihypertensive effect was much better by using combination therapy than that by monotherapy.The most effective and popular antihypertensive drug was calcium antagonists.ConclusionAntihypertensive therapy could lower SBP effectively especially by using combination therapeutic treatments.Treatment in high risk patients is strongly warranted.The most effective and popular antihypertensive drug in China is calcium antagonist.