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中国全科医学 ›› 2018, Vol. 21 ›› Issue (22): 2729-2735.DOI: 10.3969/j.issn.1007-9572.2017.00.260

所属专题： 高血压最新文章合集

• 专题研究 • 上一篇    下一篇

江西省城乡高血压患者降压药服用及血压控制现状研究

周伟1，黄晓2，游春娇2，詹碧鸣2，杨人强2，董一飞2，李菊香2，李萍2，洪葵1，2，吴延庆1，2，吴清华1，2，苏海2，鲍慧慧1，2*，程晓曙1*   

  1. 基金项目：十二五国家科技支撑计划项目（2011BAI11B01）——中国重要心血管病患病率调查及关键技术研究；江西省科技计划项目（20144BBB70006）
    1.330006江西省南昌市，南昌大学第二附属医院心血管病防治中心　2.330006江西省南昌市，南昌大学第二附属医院心血管内科
    *通信作者：鲍慧慧，副教授；E-mail：huihui_bao77@126.com　程晓曙，教授；E-mail：xiaoshumenfan@126.com
  • 出版日期:2018-08-05 发布日期:2018-08-05
  • 基金资助:
    基金项目：十二五国家科技支撑计划项目（2011BAI11B01）——中国重要心血管病患病率调查及关键技术研究；江西省科技计划项目（20144BBB70006）

Application of Antihypertensive Drugs and Blood Pressure Control among Hypertension Population in Jiangxi Province　

ZHOU Wei1，HUANG Xiao2，YOU Chun-jiao2，ZHAN Bi-ming2，YANG Ren-qiang2，DONG Yi-fei2，LI Ju-xiang2，LI Ping2，HONG Kui1，2，WU Yan-qing1，2，WU Qing-hua1，2，SU Hai2，BAO Hui-hui1，2*，CHENG Xiao-shu1*   

  1. 1.Cardiovascular Disease Prevetion and Treatment Center，the Second Affiliated Hospital of Nanchang University，Nanchang 330006，China
    2.Department of Cardiovascular Medicine，the Second Affiliated Hospital of Nanchang University，Nanchang 330006，China
    *Corresponding author：BAO Hui-hui，Associate professor；E-mail：huihui_bao77@126.com
    CHENG Xiao-shu，Professor；E-mail：xiaoshumenfan@126.com
  • Published:2018-08-05 Online:2018-08-05

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摘要： 目的　调查江西省城乡高血压患病率、知晓率、服药率及控制率，了解高血压患者降压药服用及血压控制现状。方法　于2013年11月—2014年8月在江西省随机抽取8个地区，采用简单随机抽样法在每个地区抽取2个乡镇/街道，每个乡镇/街道抽取3个村/居委会，选取15 364例年龄≥15岁且在该地区居住≥6个月的意识清晰者。通过问卷调查记录高血压患病及服药情况，并进行血压测量等体格检查，计算高血压患病率、高血压知晓率、降压药服用率、高血压总体控制率、服药后血压控制率。结果　江西省≥15岁居民高血压患病率为29.0%（4 436/15 296），标准化率（2010年中国人口标化）为14.1%，高血压知晓率为64.8%（2 874/4 436），降压药服用率为27.6%（1 223/4 436），高血压总体控制率为12.6%（561/4 436），服药后血压控制率为45.9%（561/1 223）。城市高血压患病率、高血压知晓率、降压药服用率、高血压总体控制率均高于农村，服药后血压控制率低于农村（P<0.05）。高血压患者中服药者收缩压、舒张压和脉压均低于未服药者（P<0.05）。高血压患者中，单一用药者占75.1%（918/1 223），两药联合者占12.7%（155/1 223）；不同服药方式的高血压患者服药后血压控制率比较，差异无统计学意义（χ2=2.692，P=0.611）；农村两药联合者服药后血压控制率高于城市（χ2=4.262，P=0.039）。单一用药患者中，服用钙拮抗剂（CCB）者占76.1%（699/918），服用血管紧张素转化酶抑制剂（ACEI）者占18.6%（171/918）；服用不同药物的单一用药患者服药后血压控制率比较，差异无统计学意义（χ2=6.779，P=0.148）。单一服用CCB类患者中，服用尼群地平者占39.9%（279/699），服用苯磺酸氨氯地平者占24.7%（173/699）；服用不同CCB类降压药者服药后血压控制率比较，差异无统计学意义（χ2=3.995，P=0.407）。单一服用ACEI类患者中，服用卡托普利者占76.6%（131/171），服用依那普利者占12.9%（22/171）；服用不同ACEI类降压药者服药后血压控制率比较，差异无统计学意义（χ2=2.241，P=0.524）。结论　江西省高血压患者以短效降压药治疗为主，高血压总体控制率和服药率较低；城乡高血压患者就医服药意识有待提高，政府应加大投入改善服药需求。

关键词: 高血压, 患病率, 知晓率, 服药率, 控制率

Abstract: Objective　To investigate the prevalence of hypertension，its awareness rate，medication taking rate and control rate in Jiangxi Province，and to understand the current situation of the application of antihypertensive drugs and the blood pressure control among hypertension patients.Methods　Using the simple random sampling（SRS） method，four cities in urban areas and four counties in rural areas were randomly selected，in which two districts or two townships were selected.Then，three communities or villages were selected within each district and township respectively.In these areas，a total of 15 364 participants who were 15 years or older and lived in Jiangxi Province for at least 6 months were selected from November 2013 to August 2014.Current situation of hypertension and its medication taking were recorded by questionnaires to calculate the prevalence rate of hypertension，its awareness rate，medication taking rate，overall control rate，and blood pressure control rate after taking medicine.And a physical examination including blood pressure measurement was carried out.Results　The prevalence rate of hypertension among 15 years or older population in Jiangxi Province was 29.0%（4 436/15 296） and standardized rate was 14.1%（China's population standardized rate in 2010）．The awareness rate，medication taking rate，and overall control rate of hypertension patients were 64.8%（2 875/4 436），27.6%（1 223/4 436），and 12.6%（561/4 436） respectively.Moreover，the control rate after taking medicine in patients who took the medicine was 45.9%（561/1 223）．The prevalence rate of hypertension，its awareness rate，medication taking rate，and overall control rate of participants in urban areas were higher than those in rural areas，while the control rate after taking medicine in urban areas was lower than that in rural areas（P<0.05）．The systolic blood pressure（SBP），diastolic blood pressure（DBP） and pulse pressure（PP） of patients who took the medicine were significantly lower than those who did not take the medicine（P<0.05）．Among patients with hypertension，75.1%（918
/1 223）of patients were single drug users and 12.7%（155/1 223） of patients used two-drug combinations.There is no significant difference in the control rate after taking medicine in hypertensive patients with different ways of taking medicine（χ2=2.692，P=0.611）．The control rate after taking medicine of patients using two-drug combinations in rural areas was higher than that in urban areas（χ2=4.262，P=0.039）．Among single drug users，76.1%（699/918） of patients took calcium channel blockers（CCB），and 18.6%（171/918） of patients took angiotension-converting enzyme inhibitors（ACEI）．No significant difference was observed in the control rate after taking medicine among patients using different single drugs（χ2=6.779，P=0.148）．Among patients who took CCB，39.9%（279/699）of patients took Nitrendipine and 24.7%（173/699） of patients took Amlodipine Benzenesulfonate.There was no statistical difference in the control rate after taking medicine among patients using different CCB（χ2=3.995，P=0.407）．Likewise，among patients who took ACEI，76.6%（131/171） of patients took Captopril and 12.9%（22/171）of patients took Enalapril.There was no statistical difference in the control rate after taking medicine among patients using different ACEI（χ2=2.241，P=0.524）．Conclusion　Patients with hypertension are mainly treated with short-acting antihypertensive drugs，and the medicine taking rate is low as well as the overall control rate in Jiangxi Province.Hypertension patients in both rural and urban areas need to improve their medical awareness and the government needs to increase investment to meet the demands of medicine taking.

 

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