药品
氨氯地平
血管紧张素受体阻滞剂
心脏病学
氢氯噻嗪
作者
O. Siga,Barbara Wizner,Barbara Gryglewska,J. Walczewska,Tomasz Grodzicki
标识
DOI:10.11909/j.issn.1671-5411.2019.01.001
摘要
Objective To assess antihypertensive management of older patients with poor blood pressure (BP) control. Methods Physicians, voluntary participating in the study, included six consecutive hypertensive patients during routine visits. Hypertension had to have been previously recognized and averaged office BP was ≥ 140 and/or ≥ 90 mmHg in spite of ≥ 6 weeks of antihypertensive therapy. The physicians completed a questionnaire on patients' history of cardiovascular (CV) risk factors, comorbidities, home BP monitoring, anthropometric data and the pharmacotherapy. Results Mean age of the 6462 patients was 61 years, 7% were ≥ 80 years, 51% were female. Mean ± SD office BP values were 158 ± 13/92 ± 10 mmHg. The most commonly prescribed antihypertensive drugs were: diuretics (67%), ACE inhibitors (64%), calcium channel blockers (58%) and β-blockers (54%), and their use increased with age. On monotherapy or dual therapy, 43% of the patients and 40% had their latest treatment modification within six months. Home BP monitoring was a factor that accelerated the modification of the therapy. Older patients had to have less chance on faster modification of antihypertensive therapy in spite of presence of diabetes and higher systolic BP. Conclusions Our study suggests that a large number of outpatients with poor BP control receive suboptimal antihypertensive therapy, especially in primary care. In older patients, higher BP values in the office settings are more frequently accepted by physicians even in case of higher CV risk. Regular home BP monitoring hastens the decision to intensify of antihypertensive treatment.
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