家庭血压监测患者不恰当自我干预治疗对降压达标与预后的影响

目的探讨家庭血压监测患者不恰当自我干预治疗对降压达标与预后的影响。方法选择高血压患者217例,家庭血压组112例,其中自我干预组26例,非自我干预组86例,诊所血压组105例。每月随访一次,观察血压达标情况、随访期住院次数、非致死性及致死性心脑血管事件、肾透析人数、全因死亡率,分析各组患者构成特点。随访期1年。结果①家庭血压干预组女性患者比例较高,其中白大衣效应和焦虑症者显著增高,p值分别为<0.05和<0.01。②家庭血压干预组≤3个月早期降压达标与各组比较降低,p值分别为<0.05和<0.01。≥6个月晚期达标与各组比较显著增高,p值<0.05。③家庭血压干预组入院次数的比例显著增多,p值<0.05,非致死性及致死性心脑血管事件比例增高,但与各组比较无差异性。结论家庭血压监测患者不恰当自我干预治疗对降压达标与预后有不良影响。

IMPACT OF BLOOD PRESSURE TARGET AND CARDIOVASCULAR OUTCOME ON HYPERTENSION PATIENTS UNREASONABLE INTERFERING IN MEDICAL MANAGEMENT WHEN USING HOME BLOOD PRESSURE MORITORING

Objective To explore the impact of blood pressure target goal and cardiovascular outcome on hypertension patients unreasonable interfering in medical management when using home blood pressure moritoring. Methods A total of 217 patients with hypertension were selected. Among them, Home Blood Pressure Moritofing （HBPM） group was divided into HBPM - Self Inter- feting （ HBPM - SI） group which was included 26 eases, and HBPM - Non Self Interfering （ HBPM - NSI） group which was included 86 cases; Office Blood Pressure （OBP） was included 105 cases. Fallow -up was determined once monthly; blood pressure, hospitalization, cardiovascular events, kidney dialysis and total mortality were recorded. The features of patient＇s composition were analyzed. Total fallow - up period was a year. Results ①In HBPM - SI group, female patients, white - coat effect and anxiety patients were in higher percentage, p 〈0. 05 or 〈0.01. ②Patients whose target goal was in ≤3 in HBPM - SI group were significantly lower than HBPM -NSI group or OBP group, p 〈0. 05 or 〈0. 01. Patients in target goal ≥6 months were significantly higher in HBPM - SI group than others, p 〈0. 05 ③The frequency of hospitalization in HBPM - SI group were significantly higher, p 〈0. 05 The percentage of fatal or non - fatal cardiovascular events were higher, but there were no significantly difference. Conclusions This study indicated that unreasonable interfering medical management could affect the blood pressure target goal and clinical outcome in hypertension patients when using home blood pressure moritoring.