·糖尿病心血管病·

李静 李希 冯芳 刘佳敏 高岩 张海波 张丹 乌汉毕力格 魏小帅 李丽

葛蕾 庞鑫 CHEN Yi-ping CHEN Zheng-ming LANDRAY Martin

ARMITAGE Jane CHEN Fang 蒋立新

作者单位：100037北京，中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院中国牛津国际医学研究中心(李静、冯芳、刘佳敏、高岩、张海波、张丹、乌汉毕力格、魏小帅、李丽、葛蕾、庞鑫、蒋立新);北京大学医学部公共卫生学院流行病与卫生统计学系(李希);英国牛津大学临床试验与流行病学研究中心(CHEN Yi-ping、CHEN Zheng-ming、LANDRAY Martin、ARMITAGE Jane、CHEN Fang)

通讯作者：蒋立新，E-mail: lixin.jiang@fwoxford.org

【摘要】 目的 了解中国糖尿病合并动脉粥样硬化性心血管病患者血压控制及降压药物使用情况，分析影响血压控制的因素。 方法 对参加“第二项心脏保护研究”临床试验筛选门诊的糖尿病合并动脉粥样硬化性心血管病患者进行调查，记录病史和用药情况，测量血压、BMI和腰围。 结果 2007年6月至2009年10月期间，在14个城市共调查6 522例患者，平均年龄64岁。70%有高血压病史，其中12%未服任何降压药物，仅18%血压达标。缺血性脑卒中病史(OR 0.70，95% CI 0.58～0.84)和向心性肥胖(OR 0.64， 95% CI 0.46～0.89)与血压达标呈负相关。无高血压病史的患者中，64%血压高于130/80 mm Hg。 结论 我国糖尿病合并心血管病患者血压控制情况距指南要求仍存在很大差距，应注意加强对此类患者的血压控制。

【关键词】 糖尿病;高血压;动脉粥样硬化

doi:10.3969/j.issn.1006-6187.2011.07.005

Survey of the current state of hypertension control in Chinese diabetic patients with atherosclerotic cardiovascular disease

LI Jing，LI Xi，FENG Fang，et al. China Oxford Centre for International Health Research,Cardiovascular Institute & Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China

Corresponding author：JIANG Li-xin, E-mail: lixin.jiang@fwoxford.org

【Abstract】 Objective To investigate the blood pressure control and antihypertensive medication use in diabetic patients with established atherosclerotic cardiovascular disease and determine the influencing factors of blood pressure control. Methods Diabetic patients with established atherosclerotic cardiovascular disease were screened for participation in a clinical trial. Information about their disease history and medication use was collected and a single blood pressure measurement, body mass index and waist circumference were detected. Results Between June 2007 and October 2009, 6 522 patients from 14 cities in China were interviewed. Their average age was (64±8) years and 70% patients reported a history of hypertension. However, of these patients, 12% took no antihypertensive drug and only 18% had blood pressure less than 130/80 mm Hg. A history of ischemic stroke (OR 0.70, 0.58～0.84) or abdominal obesity (OR 0.64, 0.46～0.89) were associated with poor blood pressure control. Among patients not reporting hypertension, 64% had a blood pressure ≥130/80 mm Hg. Conclusions The current state of hypertension control in China is far away from the target of hypertension control guideline. More attention should be given to antihypertensive management among these high-risk patients.

【Key words】 Diabetes mellitus; Hypertension; Atherosclerosis