Antihypertensive efficacy of treatment regimens used in veterans administration hypertension clinics
Antihypertensive efficacy of treatment regimens used in veterans administration hypertension clinics
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DOI：
10.1161/01.hyp.31.3.771
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发表时间：
1998-03-01
期刊：
影响因子：
8.3
通讯作者：
Collins, J
中科院分区：
文献类型：
--
作者：
Perry, HM;Bingham, S;Collins, J
治疗的高血压患者的发病率和死亡率是否取决于所使用的药物，还是仅仅取决于所达到的血压水平，仍然存在不确定性。这项研究在退伍军人管理局的一些特殊高血压诊所的样本中进行，以确定相关医疗服务提供者选择了哪些抗高血压药物，以及这些药物在实现正常血压方面的效果如何。从1989年5月开始，在6个退伍军人管理局高血压筛查和治疗项目诊所对6100名高血压退伍军人进行了为期46个月的随访。他们的平均年龄为60.7岁；53%居住在中风带；46%有靶器官损害，36%为黑人，23%吸烟，10%患有糖尿病。抗高血压治疗方案分为12个全面的类别。对使用一种方案的所有患者在最后一次研究随访时的血压进行平均。利尿剂或利尿剂加β受体阻滞剂方案的平均血压最低（140.6/82.3毫米汞柱），钙拮抗剂方案最高（149.0/86.5毫米汞柱）。方差分析表明，7种常见方案之间以及4种单一药物方案之间的差异具有高度显著性（P<0.001）。然而，在调整了年龄、性别、种族、吸烟、糖尿病、靶器官损害和居住地区等因素后，这些差异不再具有统计学意义（P>0.05）。这些数据表明，在这个退伍军人样本中，抗高血压药物的选择对血压控制的影响不如患者的人口统计学和临床特征重要。
There is continuing uncertainty about whether morbidity and mortality of treated hypertensive patients depends on the drug(s) used to treat or only on the level of blood pressure achieved. This study was undertaken in a sample of special Veterans Administration hypertension clinics to determine which antihypertensive drugs were selected by the involved healthcare providers and how effective they were in achieving normotension. Hypertensive veterans (n=6100) were followed in six VA Hypertension Screening and Treat ment Program clinics for 46 months beginning in May 1989. Their average age was 60.7 years; 53% lived in the Stroke Belt; 46% had target organ damage, 36% were black, 23% smoked, and 10% had diabetes mellitus. Antihypertensive regimens were divided into 12 all-inclusive categories. Blood pressures were averaged at the last study visit for all patients on a regimen. The regimens of diuretic or diuretic plus beta-blocker gave the lowest average pressures (140.6/82.3 mm Hg) and calcium antagonist the highest (149.0/86.5 mm Hg). ANOVA indicated that differences between seven common regimens and also between the four single drug regimens were highly significant (P