北京农村老年高血压患者降压药物使用及血压控制情况调查

目的了解北京农村地区老年高血压患者降压药物使用及高血压控制情况。方法对北京大兴区长子营地区1240例60岁以上正在治疗的高血压患者降压药物使用及血压控制情况进行调查。降压药分为三类:推荐制剂、传统制剂、中药制剂。推荐制剂:包括血管紧张素转换酶抑制剂(ACEI)、血管紧张素Ⅱ受体拮抗剂(ARB)、β受体阻滞剂(βRB)、钙通道阻滞剂(CCB)和噻嗪类利尿剂(HCTZ);传统制剂:包括降压0号、复方降压片、复方利血平等;中药制剂:包括罗布麻片、珍菊降压片、牛黄降压丸等。降压药物使用后血压≤140/90 mmHg为血压达标。结果 1240例调查对象中710例(57.2%)使用推荐制剂,499例(40.2%)使用传统制剂,9例(0.7%)使用中药制剂,22例(1.7%)使用推荐制剂+传统制剂;血压达标率分别为43.1%、40.7%、33.3%和54.5%;总体达标率为42.3%。使用推荐制剂患者中选用单种及两种或三种降压药联合治疗的患者分别占66.9%、31.0%和2.1%,血压达标率分别为34.1%、60.0%和80.0%。使用单种推荐制剂的患者中使用CCB、ACEI/ARB,βRB和HCTZ比例分别为62.1%、29.9%、6.3%和5.6%。使用两种推荐制剂联合治疗的患者中CCB+ACEI/ARB占83.2%,HCTZ+其他推荐制剂患者仅为2.3%。结论北京局部农村地区老年高血压治疗药物使用尚不够规范,推荐制剂使用不足60%;推荐制剂组达标率高于传统制剂组和中药制剂组。40%以上的患者使用传统制剂和中药制剂,有必要进一步探讨其降压效果和是否减少心脑血管疾病发生的循证医学证据。

Survey on antihypertensive drug administration and blood pressure control in elderly patients with hypertension in Beijing countryside

Objective To survey the antihypertensive drug administration and blood pressure （BP） control in elderly patients with hypertension in Beijing countryside. Methods The situation of antihypertensive drug administration and BP control were investigated in 1240 patients aged over 60 in Zhangziying area of Daxing District in Beijing. The antihypertensive drugs were divided into 3 types, including recommended drugs, traditional drugs and Chinese medicinal. The recommended drugs included ACEI, ARB,βRB, CCB and HCTZ, traditional drugs, Beijing antihypertension No. 0, compound antihypertensive tables and compound reserpine, and Chinese medicinal, Luobuma Pian, Zhenju Jiangya Pian and Niuhuang Jiangya Wan. After administrating antihypertensive drugs, BP≤140/90 mmHg was taken as controlled BP. Results Among 1240 cases, 710 （57.2%） took recommended drugs, 499 （40.2%）, traditional drugs, 9 （0.7%）, Chinese medicinal and 22 （1.7%）, recommended drugs and traditional drugs. The BP control rate was, respectively, 43.1%, 40.7%, 33.3%and 54.5%, and the total control rate was 42.3%. Among the patients took recommended drugs, 66.9%took single drug, 31.0%, two kinds drugs and 2.1%, 3 kinds of drugs, and BP control rate was, respectively, 34.1%, 60.0%and 80.0%. In single recommended drug, the percentage of CCB, ACEI/ARB,βRB and HCTZ was, respectively, 62.1%, 29.9%, 6.3%and 5.6%. Among the patients took two kinds of recommended drug, 83.2% took CCB＋ACEI/ARB and only 2.3%, HCTZ＋other recommended drugs. Conclusion The administration of antihypertensive drugs is not normative enough and the percentage of patients took recommended drugs is not reached 60%in elderly patients with hypertension in Beijing countryside. BP control rate is higher in recommended drug group than that in traditional drug group and Chinese medicinal group. As over 40%of patients are taking traditional drugs and Chinese medicinal, it is necessary to discuss further the EBM evidences of their effects of decreasing BP and incidence of cardiovascular diseases.