女性冠心病患者血压控制达标率的现状调查

目的了解中国女性冠心病（coronary heart disease,CHD）患者血压达标现况。探讨影响女性CHD患者血压达标的相关危险因素。方法入选2006年6月至2007年1月,上海、北京、天津、广东、浙江和新疆等6个地区城市66家医院心内科门诊诊断为CHD的女性患者。将血压≤130/80 mmHg作为CHD患者血压达标目标值。结果女性CHD患者血压达标率为16.7%。血压非达标组总胆固醇≥5.7mmol/L及低密度脂蛋白胆固醇（LDL-C）〉3.6mmol/L患者比例高于血压达标组（P〈0.01）。二分类Logistic向前逐步回归分析显示,影响女性CHD患者血压达标的相关因素的OR值分别为：糖尿病家族史1.70（95%CI：1.02～2.82）、LDL-C〉3.6 mmol/L者1.92（95%CI：1.34～2.76）、办公室工作者0.66（95%CI：0.48～0.90）。收缩压〈110 mmHg和（或）舒张压〈60 mmHg组急性心肌梗死史、冠脉造影显示≥2支冠脉病变及有介入手术史的患者比例均高于收缩压≥110 mmHg且舒张压≥60 mmHg组（P〈0.05）。结论我国女性CHD患者的血压达标率较低,糖尿病家族史及LDL-C〉3.6 mmol/L是影响女性CHD患者血压达标的危险因素。

Status of blood pressure control among female outpatients with coronary heart disease in China

Objective To investigate status of blood pressure(BP) treatment-goal attainment among female outpatients with coronary heart disease(CHD) and to identify factors associated with the goal achievement.Methods In this cross-sectional study,female participants with CHD were recruited from 66 hospitals in Beijing,Shanghai,Tianjin,Guangdong,Zhejiang and Xinjiang in China.Using systolic blood pressure(SBP) < 130 mmHg and diastolic blood pressure(DBP) <80 mmHg as BP goal attainment.Results The success rate for achieving BP goal among female CHD patients with hypertension was only 16.7%.The risk factors associated with achieving the BP goal for female CHD outpatients with hypertension were family history of diabetes(OR;1.70;95%CI;1.02～2.82), LDL-C>3.6 mmol/L(OR:1.92;95%CI:1.34～2.76),and office work(0fl:0.66;95%CI: 0.48～0.90).The prevalence of acute myocardial infarction,percutaneous coronary intervention and coronary angiography showing more than one team of coronary lesions were significantly higher among CHD outpatients with SBP < 110 mmHg and/or DBP < 60 mmHg than those with SBP≥110 mmHg and DBPS≥60 mmHg(P <0.05).Conclusion The BP control goal attainment is low among female CHD outpatients with hypertension.Family history of diabetes,LDL-C >3.6 mmol/L and office work are significantly associated with achieving BP goal.