Sex differences in antihypertensive drug use and blood pressure control
Sex differences in antihypertensive drug use and blood pressure control
复制标题
抗高血压药物使用和血压控制的性别差异
DOI：
10.1136/postgradmedj-2019-136513
复制
发表时间：
2019-06-01
影响因子：
5.1
通讯作者：
Li, Xiaogang
中科院分区：
文献类型：
--
作者：
Wang, Junwen;Jiang, Weihong;Li, Xiaogang
背景：高血压是最重要的可改变的心血管危险因素。流行病学研究已经表明降低血压（BP）的好处，但血压控制是一个主要的挑战。此外，在降压药使用和血压控制方面存在显著的性别差异。本研究探讨了降压药使用和血压控制的性别差异，旨在减少高血压并发症，提高生活质量。方法本研究在我院高血压门诊进行，纳入1529例无继发性高血压或合并症的患者。本研究调查了男性和女性血压控制率和抗高血压药物使用模式。所有数据均通过结构化问卷调查和患者测量收集。结果共纳入男性713人，女性816人。低龄组女性高血压发生率较低（16.2%比11.6%,p<0.05），但中年组（47.8%比49.9%,p<0.05）和老年组（36.0%比38.5%,p<0.05）女性高血压发生率差异消失。男女血压控制率差异有统计学意义（男性35.6%，女性31.9%,p<0.01）。男女血压控制率总体差异（男性35.6%，女性31.9%,p<0.01）。在18-44岁的男性中，血管紧张素转换酶抑制剂（ACEIs）的控制率最好，而钙通道阻滞剂（CCBs）的控制率最低（ACEIs组为61.5%，CCBs组为28.6%,p<0.05）。45 ~ 64岁女性中，利尿剂（DUs）控制率最高，CCBs控制率最低（DUs为47.5%，CCBs为28.3%,p<0.05）。结论性别在血压控制中起重要作用。在18-44岁的人群中，使用acei的男性控制率最好。在45-64岁的人群中，使用DUs的女性控制率最好。本研究为根据性别和年龄选择降压药提供了依据。
Background Hypertension is the most important modifiable cardiovascular risk factor. Epidemiological studies have shown the benefits of lowering blood pressure (BP), but BP control is a major challenge. Furthermore, there are significant sex differences in antihypertensive drug use and BP control. This study examined sex differences in antihypertensive drug use and BP control, with the aim of reducing the complications of hypertension and improving quality of life. Methods The study was performed in our outpatient hypertension clinic, and included 1529 patients without secondary hypertension or comorbidities. The study, investigated BP control rates and patterns of antihypertensive drug use in male and female. All data were collected using structured questionnaires and patient measurements. Results The study included 713 males and 816 females in this study. Fewer females had hypertension in the younger age group (16.2% vs 11.6%; p>0.05), but this difference disappeared in middle-aged (47.8% vs 49.9 %; p<0.05) and elderly age groups (36.0% vs 38.5%; p<0.05). BP control rates differed between males and females (35.6% in male, 31.9% in female, p<0.01). There was an overall difference in BP control rates between males and females (35.6% in males, 31.9% in females, p<0.01). In this aged 18–44 years, angiotensin converting enzyme inhibitors (ACEIs) showed the best control rate in males, while calcium channel blockers (CCBs) were least effective (61.5% with ACEIs, 28.6% with CCBs; p<0.05). In this aged 45–64 years, diuretics (DUs) showed the best control rate in females, while CCBs were least effective (47.5% with DUs, 28.3% with CCBs; p<0.05). Conclusions Sex plays an important role in BP control. In those aged 18–44 years, males using ACEIs showed best control rates. In those aged 45–64 years, females using DUs showed best control rates. Our study provides a basis with the selection of antihypertensive drugs according to sex and age.