Antihypertensive medication use among US adults with hypertension
Antihypertensive medication use among US adults with hypertension
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DOI：
10.1161/circulationaha.105.542290
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发表时间：
2006-01-17
期刊：
影响因子：
37.8
通讯作者：
Burt, V
中科院分区：
文献类型：
--
作者：
Gu, QP;Paulose-Ram, R;Burt, V
背景 - 高血压可以通过现有的降压药物治疗得到控制。本研究调查了美国成人高血压患者处方降压药的使用趋势，并将药物使用模式与第六届全国高血压预防、检测、评估和治疗联合委员会的建议进行了比较。方法与结果 - 根据血压 >= 140/90 mm Hg 或自我报告目前正在使用处方药治疗高血压的情况，全国健康与营养调查中年龄大于等于 18 岁的人被确定为高血压患者。1999 - 2002 年，62.9% 的美国成人高血压患者服用处方抗高血压药物，而 1988 - 1994 年期间只有 57.3% （P < 0.01）。男性服用降压药的比例增幅最大（1988-1994 年为 47.5%，1999-2002 年为 57.9%[P<0.001]）。在这两次调查中，抗高血压药物的使用随着年龄的增长而增加，男性低于女性，墨西哥裔美国人低于非西班牙裔白人和黑人。使用多种降压药的比例从 29.1% 上升到 35.8%（P < 0.001）。钙通道阻滞剂、β-受体阻滞剂或血管紧张素转换酶抑制剂的多重治疗分别显著增加了30%、42%和68%，而利尿剂或β-受体阻滞剂的单一治疗则显著减少。对于患有糖尿病、充血性心力衰竭或曾有过心脏病发作的高血压患者，其用药模式与第六次全国联合委员会指南的建议密切相关。结论 - 在过去 10 年中，美国成人高血压患者的抗高血压药物使用率和多种抗高血压药物使用率均有所上升，但社会人口因素导致的差异依然存在。
Background - High blood pressure can be controlled through existing antihypertensive drug therapy. This study examined trends in prescribed antihypertensive medication use among US adults with hypertension and compared drug utilization patterns with recommendations of the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.Methods and Results - Persons aged >= 18 years from the National Health and Nutrition Examination Surveys were identified as hypertensive on the basis of either a blood pressure >= 140/90 mm Hg or self-reported current treatment for hypertension with a prescription medication. In 1999 - 2002, 62.9% of US hypertensive adults took a prescription antihypertensive medication compared with 57.3% during 1988 - 1994 ( P < 0.01). Men had the greatest increase in antihypertensive medication use (47.5%, 1988 - 1994 versus 57.9%, 1999 - 2002 [ P < 0.001]). In both surveys, antihypertensive medication use increased with age, was lower among men than among women, and was lower among Mexican Americans than among non-Hispanic whites and blacks. Multiple antihypertensive drug use increased from 29.1% to 35.8% ( P < 0.001). Polytherapy with a calcium channel blocker, beta-blocker, or angiotensin-converting enzyme inhibitor significantly increased by 30%, 42%, and 68%, respectively, whereas monotherapy with a diuretic or beta-blocker significantly decreased. For hypertensives with diabetes, congestive heart failure, or a prior heart attack, the utilization patterns closely followed the Sixth Joint National Committee guideline recommendations.Conclusions - Antihypertensive medication use and multiple antihypertensive medication use among US hypertensive adults increased over the past 10 years, but disparities by sociodemographic factors continue to exist.