血压控制不达标患者血压特征及与缺血性脑卒中的关系

目的：了解血压控制不达标高血压患者收缩压、舒张压、脉压、平均动脉压、血压控制不达标类型以及血压分级等血压特点及其与脑卒中患病情况的关系。方法：2012年3月至12月在北京安贞医院门诊及所属社区卫生服务中心门诊筛查血压控制不达标的高血压患者,共收集血压控制不达标高血压患者3909人。结果：研究对象男性占49.4%,女性占50.6%。62.2%患者服用一种降压药,37.8%联合用药。144例患缺血性脑卒中,患病率为3.68%。多因素回归分析发现,和收缩压及舒张压均未控制的患者相比,单纯舒张压控制不达标者脑卒中的患病危险低,OR=0.339(95%CI:0.124-0.923)。和收缩压＜140 mmHg者相比,收缩压高于150mmHg者缺血性脑卒中的患病危险增加,收缩压150~159mmHg以及≥160mmHg者相对危险度分别为2.532 (95%CI:1.266-5.067),和2.004(95%CI:1.010-3.979)。而脉压差、平均动脉压、舒张压以及血压分级在多因素分析中均为显示与缺血性脑卒中的相关关系。结论：单纯舒张压控制不达标类型以及收缩压水平与缺血性脑卒中的患病危险相关。单纯舒张压控制不达标的患者以及收缩压高于150 mmHg者缺血性脑卒中的患病危险增加。

Blood pressure characteristics and relation to ischemic stroke among patients with uncontrolled hypertension Shan Zhuohua, Deng Liqun,, Zuo Huijuan., Beijing Anzhen Hospital affiliated to the Capital University of Medical Sciences,Beijing Institute of Heart, Lung Blood Vessel Diseases, Beijing 100029,China

Objective: To study the relation between ischemic stroke and blood pressure characteristics of hypertension patients with poorly controlled blood pressure, namely systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, the type of poorly controlled blood pressure and blood pressure classification and so on. Methods: 3909 hypertension patients with poorly controlled blood pressure were collected by screening in the clinic of Anzhen Hospital and the relevant community health service center from March to December 2012. Results: There were 49.4% males and 50.6% females in total of 3909 patients. 62.2% of patients took a hypertensive medicine, and 37.8% took a few different medicines. The morbidity was 3.68% among 144 cases of ischemic stroke. Multiple-factor regression analysis found that the risk of ischemic stroke among the patients with poorly controlled simple diastolic pressure is lower than the patients who did not control systolic pressure and diastolic pressure, OR = 0.339 (95% CI: