成都市雙楠社區高血壓綜合干預治療現狀調查_《中國循證醫學雜志》

作者：

陳旸 ¹ , 劉明江 ¹ , 葉志君 ²

1. 四川省人民醫院心內科（成都 610072）；2. 四川省人民醫院雙楠門診部（成都 610072）;

關鍵詞：

高血壓社區治療性生活方式改善綜合干預

DOI：

10.7507/1672-2531.20090212

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目的　了解城市社區高血壓綜合干預治療現狀，為探索城市社區高血壓防治干預方式提供證據。
方法　采用分層隨機抽樣的方法，抽取成都市雙楠社區原發性高血壓患者136 例，其中男性77 例，女性59 例，平均年齡59±3.9 歲。按其使用降壓藥物種類的不同進行分組，觀察各組治療3 個月后的順從指數（CI）、達標率；并在此基礎上對患者進行為期3 個月的治療性生活方式改善（TLC）干預，以觀察比較TLC 干預前后患者血壓水平、達標率。
結果　聯合用藥組（n=12）達標率最高（83.3%），長效鈣通道阻滯劑組（n=31）達標率（54.8%）及CI（91.4%）均較高，短效制劑組（n=25）達標率（8.0%）及CI（41.2%）均最低；進行TLC 干預后，患者血壓水平明顯下降，達標率增加，干預前后差異有統計學意義（P lt;0.05）。
結論　本調查結果提示，應加強對城市社區高血壓患者綜合干預方式的規范化，積極實施在TLC 基礎上合理用藥的方案。

引用本文： 陳旸,劉明江,葉志君. 成都市雙楠社區高血壓綜合干預治療現狀調查. 中國循證醫學雜志, 2009, 09(11): 1169-1172. doi: 10.7507/1672-2531.20090212 復制

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2.	中國高血壓防治指南修訂委員會. 中國高血壓防治指南(2005年修訂版). 北京: 人民衛生出版社, 2006, 8.
3.	Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension, 2006, 47(2): 296-308.
4.	Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28 (12): 1462-1536.
5.	Poulter NR, Wedel H, Dahlof B, et al. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA). Lancet, 2005, 366(9489): 907-913.
6.	Jamerson K, Weber MA, Bakris GL, et al. (ACCOMPLISH investigators) Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med, 2008, 359(23): 2417-2428.
7.	Expert Paned on Detection, Evaluation, and treatment of high blood cholesterol in adults. Summary of the third report of the nation cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol (adult treatment panel Ⅲ). JAMA, 2001, 285(10): 2486-2497.
8.	National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 2003, 289(19): 2560-2572.
9.	DASH-Sodium Trial Collaborative Research Group. Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 2003, 42 (1): 8-13.
10.	孫高峰, 阿麗婭?買買提熱依木. 我國高血壓社區綜合干預方法及效果評價研究進展. 中國慢性病預防與控制, 2007, 15(5): 509.

1. Bavikati VV, Sperling LS, Salmon RD, et al. Effect of comprehensive therapeutic lifestyle changes on prehypertension. AmJ Cardiol, 2008, 102(12): 1677-1680.
2. 中國高血壓防治指南修訂委員會. 中國高血壓防治指南(2005年修訂版). 北京: 人民衛生出版社, 2006, 8.
3. Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension, 2006, 47(2): 296-308.
4. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 2007, 28 (12): 1462-1536.
5. Poulter NR, Wedel H, Dahlof B, et al. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA). Lancet, 2005, 366(9489): 907-913.
6. Jamerson K, Weber MA, Bakris GL, et al. (ACCOMPLISH investigators) Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med, 2008, 359(23): 2417-2428.
7. Expert Paned on Detection, Evaluation, and treatment of high blood cholesterol in adults. Summary of the third report of the nation cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol (adult treatment panel Ⅲ). JAMA, 2001, 285(10): 2486-2497.
8. National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 2003, 289(19): 2560-2572.
9. DASH-Sodium Trial Collaborative Research Group. Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 2003, 42 (1): 8-13.
10. 孫高峰, 阿麗婭?買買提熱依木. 我國高血壓社區綜合干預方法及效果評價研究進展. 中國慢性病預防與控制, 2007, 15(5): 509.

《中國循證醫學雜志》

成都市雙楠社區高血壓綜合干預治療現狀調查

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《中國循證醫學雜志》

成都市雙楠社區高血壓綜合干預治療現狀調查

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