Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders
Hypertension and antihypertensive treatment in veterans with spinal cord injury and disorders
复制标题
患有脊髓损伤和疾病的退伍军人的高血压和抗高血压治疗
DOI：
10.1038/sc.2012.122
复制
发表时间：
2012
期刊：
影响因子：
2.2
通讯作者：
B. Smith
中科院分区：
文献类型：
--
作者：
W. Barry;J. S. Andre;C. Evans;S. Sabharwal;S. Miskevics;F. Weaver;B. Smith
目的：高血压（HTN）是心血管疾病的重要危险因素，是脊髓损伤和疾病（SCI/D）患者发病和死亡的主要原因。我们的研究检查了脊髓损伤/D退伍军人HTN的患病率、相关因素和药物治疗，并与匹配的对照组进行了比较。方法：回顾性分析创伤性脊髓损伤/D （TSCI/D; n=6672）、非创伤性脊髓损伤/D （NTSCI/D; n=3566）和匹配的非损伤队列。结果：超过一半的TSCI/D患者（56.6%）有HTN，而匹配对照组为68.4% （P<0.001）。与对照组相比，患有TSCI/D的截瘫和四肢瘫痪退伍军人被诊断为HTN的几率显著降低(优势比(OR)=0.84 (0.77-0.91)；= 0.38(0.35 - -0.42))。约71.8%的NTSCI/D患者有HTN，对照组为72.3% （P < 0.05）。与对照组相比，患有NTSCI/D的截瘫和四肢瘫痪退伍军人HTN诊断的几率无显著差异(OR=0.92 (0.79-1.05)；= 0.85(0.71 - -1.01))。调整分析显示，患有四肢瘫痪和HTN的退伍军人接受降压治疗的可能性较低(TSCI/D， OR=0.62 (0.53-0.71)；Ntsci / d, or =0.81(0.66-0.99))。结论：HTN在SCI/D退伍军人中比以往报道的更为普遍。TSCI/D退伍军人HTN患病率明显低于非SCI/D退伍军人，而NTSCI/D退伍军人HTN患病率与非SCI/D退伍军人相当。损伤程度（四肢瘫痪与截瘫）对创伤队列中HTN的患病率有很大影响。随后的降压治疗在TSCI/D和NTSCI/D退伍军人中较少使用，而在TSCI/D退伍军人中更多使用截瘫。
Objectives:Hypertension (HTN) is an important risk factor for cardiovascular disease, a major cause of morbidity and mortality among people with spinal cord injury and disorders (SCI/D). Our study examined prevalence, associated factors, and pharmacological treatment of HTN in Veterans with SCI/D compared with a matched control group.Methods:A retrospective review was conducted of Veterans with traumatic SCI/D (TSCI/D; n=6672), non-traumatic SCI/D (NTSCI/D; n=3566) and a matched, non-injured cohort.Results:Over half of patients with TSCI/D (56.6%) had HTN, compared with 68.4% of matched controls (P<0.001). Paraplegic and tetraplegic Veterans with TSCI/D had significantly lower odds of having a HTN diagnosis compared with control (odds ratios (OR)=0.84 (0.77–0.91); OR=0.38 (0.35–0.42)). About 71.8% of patients with NTSCI/D had HTN compared with 72.3% of matched controls (P>0.05). Paraplegic and tetraplegic Veterans with NTSCI/D did not have significantly different odds of a HTN diagnosis compared with control (OR=0.92 (0.79–1.05); OR=0.85 (0.71–1.01)). Adjusted analysis indicates that Veterans with tetraplegia and HTN were less likely to receive antihypertensive therapy (TSCI/D, OR=0.62 (0.53–0.71); NTSCI/D, OR=0.81 (0.66–0.99)).Conclusion:HTN appears to be more prevalent in SCI/D Veterans than previously reported. TSCI/D Veterans have a significantly lower prevalence of HTN whereas NTSCI/D Veterans have a comparable prevalence of HTN to those without SCI/D. The level of injury (tetraplegia vs paraplegia) has a large impact on the prevalence of HTN in the traumatic cohort. Subsequent antihypertensive therapy is used less in both TSCI/D and NTSCI/D Veterans with tetraplegia and more in TSCI/D Veterans with paraplegia.