Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic
Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic
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常用高血压治疗方式的疗效比较：对高血压诊所 1900 名参与者的回顾性研究
DOI：
10.12659/msm.921211
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发表时间：
2020-04-30
影响因子：
3.1
通讯作者：
Li, Xiaogang
中科院分区：
文献类型：
--
作者：
Zhao, Xiexiong;Dahal, Anu;Li, Xiaogang
背景：尽管有多种降压药物可供选择，但一些高血压患者存在血压失控现象，尤其是在临床上。本研究的目的是比较我们高血压(HTN)临床中不同降压疗法(单一疗法与联合疗法、固定剂量联合疗法(FDC)与自由等效联合疗法(FEC)、利尿剂与非利尿剂)的疗效。材料/方法本研究选择2016年6月至2017年2月在湘雅第三医院HTN门诊就诊的高血压病患者。收集了参与者的基本特征、血压数据和治疗方式的数据。计算和比较参与者在接受降压药物治疗后达到目标血压的比例。结果在1,900名受试者中，联合疗法的控制效果优于单一疗法(P<；0.0005)。当两种药物联合治疗HTN时，FEC的使用频率明显高于FDC(P<；0.0005)。在3级HTN中，FDC的控制率较高(P=0.002)。联合用药2、3级的控制率分别为42.1%和38.5%(P=0.724；36.2%和31.0%，P=0.526)。使用利尿剂的患者控制率(43.1%)高于不使用利尿剂的患者(36.9%，P=0.025)。结论在我们的临床中，FEC的使用频率高于FDC。当血压显著升高时，特别是在2级或3级时，FDC似乎比FEC有更好的控制率。利尿剂治疗能更有效地控制HTN。
Background Although various antihypertensive medications are available, some hypertensive patients have uncontrolled blood pressures, especially in the clinic. The aim of the present study was to compare the efficacies of various antihypertensive therapies in our hypertension (HTN) clinic (monotherapy vs. combination therapy, fixed-dose combination (FDC) versus free equivalent combination (FEC), and diuretics versus non-diuretics. Material/Methods In this retrospective study, patients at the HTN clinic of the Third Xiangya Hospital with primary hypertension were enrolled from June 2016 to February 2017. Data on participants’ basic characteristics, blood pressure data, and treatment modalities were collected. The proportions of participants attaining target blood pressure after treatment with antihypertensive modalities were calculated and compared. Results Among 1900 participants, combination therapy had a better control efficacy than monotherapy (P<0.0005). When HTN was treated by 2 kinds of drugs, FEC was used much more frequently than FDC (P<0.0005). In grade 3 HTN, FDC had a higher control rate (P=0.002). If more than 2 kinds of drugs were used, FDC+OTHER had a slightly higher control rate in grade 2 and 3 (42.1% vs. 38.5%, P=0.724; 36.2% vs. 31.0%, P=0.526, respectively). Therapies with diuretics had better control rates than those without diuretics (43.1% vs. 36.9%, P=0.025). Conclusions In our clinic, FEC was prescribed more often than FDC. When blood pressure is significantly elevated, especially at levels 2 or 3, FDC seems to have a better control rate than FEC. Therapies with diuretics controlled HTN more efficiently.