Antihypertensive Prescriptions for Newly Treated Patients Before and After the Main Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Results and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Guidelines
Antihypertensive Prescriptions for Newly Treated Patients Before and After the Main Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Results and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Guidelines
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DOI：
10.1161/hypertensionaha.108.120154
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发表时间：
2009-04-01
期刊：
影响因子：
8.3
通讯作者：
Whelton, Paul K.
中科院分区：
文献类型：
--
作者：
Muntner, Paul;Krousel-Wood, Marie;Whelton, Paul K.
2002年12月发表了抗高血压降脂治疗预防心脏病试验的主要结果。2003年5月发表的全国高血压预防、检测、评估和治疗联合委员会第七次报告推荐噻嗪类利尿剂作为大多数高血压患者单独或与其他药物联合使用的初始药物治疗。为了评估这些出版物之前和之后的变化，我们比较了大型管理医疗组织在 3 个时间段内开始药物抗高血压治疗的患者所开的抗高血压药物处方：(1) 2001 年 7 月 1 日至 2002 年 6 月 30 日（在这些出版物之前；n=1354）； (2) 2003年7月1日至2004年6月30日（评估短期变化；n=1542）； (3) 2004年7月1日至2005年6月30日（评估扩展的变更；n=1865）。 2001-2002年和2003-2004年期间，开始使用噻嗪类利尿剂降压治疗的患者比例从30.6%增加到39.4%（P < 0.001），2004-2005年这一增幅保持在36.5%（与2001-2002年和2001-2002年相比，P < 0.001）。与2003-2004年相比P=0.33)。在没有糖尿病、肾病、心肌梗死或心力衰竭病史的患者中，开始使用噻嗪类利尿剂进行药物降压治疗的百分比从2001-2002年的33.1%增加到2003-2004年的43.4%（P<0.001），并在2004-2005年保持增加（41.0%） （分别与 2001-2002 年和 2003-2004 年相比，P < 0.001 和 P=0.23）。尽管噻嗪类利尿剂的使用持续增加，但本研究表明，有机会提高对预防、检测、评估和治疗高血压指南国家联合委员会第七次报告的遵守率。 （高血压。2009；53：617-623。）
Main results of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial were published in December 2002. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, published in May 2003, recommended thiazide-type diuretics as initial pharmacological treatment alone or in combination with another drug in most patients with hypertension. To assess changes from before to after these publications, we compared antihypertensive medication prescriptions filled by patients who initiated pharmacological antihypertensive treatment in a large managed care organization during 3 time periods: (1) July 1, 2001, to June 30, 2002 (before these publications; n=1354); (2) July 1, 2003, to June 30, 2004 (to assess short-term changes; n=1542); and (3) July 1, 2004, to June 30, 2005 (to assess extended changes; n=1865). The percentage of patients initiating antihypertensive treatment with a thiazide-type diuretic increased from 30.6% to 39.4% (P < 0.001) between 2001-2002 and 2003-2004, and the increase was maintained at 36.5% in 2004-2005 (P < 0.001 compared with 2001-2002 and P=0.33 compared with 2003-2004). Among patients without diabetes mellitus, renal disease, a history of myocardial infarction, or heart failure, the percentage initiating pharmacological antihypertensive treatment with a thiazide-type diuretic increased from 33.1% in 2001-2002 to 43.4% in 2003-2004 (P < 0.001) and remained increased (41.0%) in 2004-2005 (P < 0.001 and P=0.23 compared with 2001-2002 and 2003-2004, respectively). Despite a sustained increase in the use of thiazide-type diuretics, this study indicates that an opportunity exists to increase adherence to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines. (Hypertension. 2009;53:617-623.)