文章摘要
张海龙,赵宝成,刘育鹏,唐庆龙,林明芳.老年高血压合并冠心病患者的血压达标情况及影响因素分析[J].中国临床保健杂志,2019,22(1):51-55.
老年高血压合并冠心病患者的血压达标情况及影响因素分析
Analysis of blood pressure control situation and related factors in elderly patients with coronary heart disease and hypertension
投稿时间:2018-05-09  
DOI:10.3969/J.issn.1672-6790.2019.01.015
中文关键词: 高血压  冠心病  血压达标情况  尿酸  危险因素
英文关键词: Hypertension  Coronary disease  Blood pressure control situation  Uric Acid  Risk factors 〖FL
基金项目:
作者单位E-mail
张海龙 中央军委政治工作部机关门诊部保健科,北京 100120 zhanghailong1432@163.com 
赵宝成 中央军委政治工作部机关门诊部保健科,北京 100120  
刘育鹏 中央军委政治工作部机关门诊部保健科,北京 100120  
唐庆龙 中央军委政治工作部机关门诊部保健科,北京 100120  
林明芳 首都医科大学附属安贞医院心内科  
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中文摘要:
      目的 探讨老年高血压合并冠心病患者的血压达标情况及影响因素。方法 选取在门诊就诊的195例老年高血压合并冠心病患者为研究对象,根据血压控制标准分为达标组和未达标组,比较两组的基线资料与临床特征,采用多因素logistic回归分析来探讨血压未达标的独立影响因素。结果 (1)全部患者中实现血压达标78例,达标率为40.0%。未达标组的年龄、体质指数(BMI)、腰围、饮酒史、高盐饮食、糖尿病比例分别为(73.0±3.8)岁、(25.7±5.1)kg/m2、(98.7±40.3)cm、39.3%、41.9%、65.8%,显著高于达标组的(71.8±3.3)岁、(23.8±4.3)kg/m2、(85.6±32.6)cm、24.4%、26.9%、48.7%,规律体育锻炼的比例为21.4%,显著低于达标组的35.9%,差异均有统计学意义(P<0.05)。(2)未达标组的心率、血总胆固醇与尿酸(UA)的水平分别为(98.6±40.7)次/分钟、(4.43±1.09)mmol/L、(339.8±97.6)μmol/L,均显著高于达标组的(85.8±35.3)次/min、(4.11±1.05)mmol/L、(303.8±85.7)μmol/L,血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂、规律用药的比例分别为45.3%、41.9%,显著低于达标组的61.5%、61.5%,差异均有统计学意义(P<0.05)。(3)多因素logistic回归分析结果表明,BMI、UA升高是血压未达标的独立危险因素,规律用药是其独立保护因素(P<0.05)。结论 门诊老年高血压合并冠心病患者的血压达标率不高,BMI、UA升高能显著增加血压未达标率,而规律用药有助于提高血压的控制效果。
英文摘要:
      Objective To study the blood pressure control situation and related factors in elderly patients with coronary heart disease and hypertension. Methods 195 elderly patients with coronary heart disease and hypertension were enrolled in the study and divided into the controlled group and the un-controlled group according to the standard of blood pressure control.Baseline data and clinical characteristics were compared between two groups,multivariate logistic regression analysis was used to explore the independent factors of blood pressure non-control. Results (1) 78 patients achieved blood pressure control,and the control rate was 40.0%.The age,body mass index(BMI),waist circumference,rate of alcohol drinking,high salt diet and diabetes in un-controlled group were (73±3.8)years old,(25.7±5.1)kg/m2,(98.7±40.3)cm,39.3%,41.9%,65.8% respectively,which were significantly higher than (71.8±3.3)years old,(23.8±4.3)kg/m2,(85.6±32.6)cm,24.4%,26.9%,48.7% in controlled group,and the rate of patients who take regular physical exercise was 21.4%,which was significantly lower than 35.9% that in un-controlled group (P<0.05).(2) The heart rate,blood levels of total cholesterol and uric acid(UA) group in un-controlled group were (98.6±40.7)/min,(4.43±1.09)mmol/L,(339.8±97.6)μmol/L respectively,which were significantly higher than (85.8±35.3)/min,(4.11±1.05)mmol/L,(303.8±85.7)μmol/L in controlled group,and the dosage rate of angiotensin converting enzyme inhibitors/angiotensin receptor blockers and regular medication in un-controlled group were 45.3%,41.9%,which were significantly lower than 61.5%,61.5% in controlled group (P<0.05).(3) Results of multivariate logistic regression analysis showed that the increases of BMI and UA were independent risk factors of failing control of blood pressure while regular medication was an independent protective factor (P<0.05). Conclusion The blood pressure control rate of elderly patients with coronary heart disease and hypertension is not high.The increases of BMI and serum UA could significantly raise the un-control rate of blood pressure,and regular medication is helpful to improve blood pressure control effect.
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