在不受控制的高血压中,治疗加剧的预测因素
Koushik Kasanagottu1,2, Kenneth J Mukamal1,2, Bruce E Landon1,3
1Division of General Medicine, Beth Israel Deaconess Medical Center, Brookline.
Journal of hypertension
|October 27, 2023
概括
对不受控制的高血压的治疗强化是罕见的,即使是初级保健医生. 服用较少药物的患者或由覆盖性提供者看到的患者为改善高血压管理提供了机会.
科学领域:
- 心脏病学 心脏病学
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 失控高血压 (HTN) 的管理往往缺乏治疗强化.
- 初级保健医生 (PCP) 很少在患者访问期间加强HTN治疗.
研究的目的:
- 确定治疗强化治疗失控高血压的预测因素.
- 评估在初级保健机构中影响HTN治疗强化因素.
主要方法:
- 使用全国代表性的国家门诊医疗调查 (NAMCS) 数据 (2008-2018) 的横截面研究.
- 分析了18岁及以上的无控HTN患者 (SBP≥140 mmHg和/或DBP≥90 mmHg) 的访问情况.
- 治疗强化定义为添加新的血压药物.
主要成果:
- 在8010万个国家访问中,有10.3%的不受控制的HTN导致治疗加剧.
- 与患者自己的PCP的访问显示出比访问其他PCP (5.9%) 更高的强化率 (10.8%).
- 服用较少抗高血压药物的患者的强化率较低;并发症没有显著影响强化.
结论:
- 对失控高血压的治疗加剧仍然很少发生.
- 有机会加强HTN管理,特别是对于服用较少药物的患者或通过覆盖提供者看到的患者.
- 改善HTN护理需要针对药物强化制定有针对性的策略.
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