Investigation And Analysis On The Pharmacological Therapy For Patients With Hypertension In Three Different Levels Of Hospitals In Fujian Province In 2003 And 2007

Objective The aim of this paper is to investigate the pharmacological therapy for hospitalized patients with hypertension in three different levels of hospitals in Fujian Province(FuJian Provincial hospital:the third grade class A hospital;the first hospital of QuanZhou:the third grade class B hospital;WuYiShan municipal hospital:the second grade class A hospital) in 2003 and 2007.To understand the changes of pharmacological therapy between 2007 and 2003,and the distance between clinical practice and the guidelines.To analyze the reasons of the above changes and distance.Furthermore,to improve the drug therapy standard for hypertension in future.Method Each 300 cases of hospitalized patients with hypertension in 2003 and 2007 which from FuJian Provincial hospital,the first hospital of QuanZhou and WuYiShan municipal hospital were collected respectively. According to the year ,level of hospital,the patients were divided into following groups:(1)group 2003 and group 2007(2)the third grade class A hospital group,the third grade class B hospital group and the second grade class A hospital group.Results (1)Compared group 2007 with group 2003,in the third grade class A hospital,the use ofβ-blockers and angiotensin II receptor blocker(ARB) were both incresed significantly (29.0%VS16.7%,30.0%VS8.3%,P<0.05),the use of diuretics and angiotensin converse enzyme inhibitor(ACEI) were both decreased significantly (10.3%VS24.3%,37.7%VS49.0%,P<0.05);The ratio of combinative administration was incresed significantly (P<0.05);The control rates for blood pressure were not different(P>0.05).In the third grade class B hospital,only the use of ARB was incresed significantly(12.3%VS3.3%,p<0.05);the ratio of three-drug treatment or more was increased significantly (P<0.05);the control rates for blood pressure were also increased significantly (P<0.05). In the second grade class A hospital,the use ofβ-blockers was incresed significantly(34.7%VS25.3%,P<0.05), the use of ACEI,the total use of ACEI or ARB were both decreased significantly(37.7%VS54.3%,39.0%VS55.3%,P<0.05);the ratio of combinative administration and the control rates for blood pressure were both not significantly different(P>0.05).(2) Compared with each other in group 2003,the use of Calcium Channel Blockers(CCB) and ARB(P<0.017) in the third grade class A hospital were much higher than other levels of hospitals,but the use ofβ-blockers was much lower(P<0.017).In group 2007,the use of diuretics in the third grade class a hospital was much lower than other levels of hospitals(P<0.017);the use of ARB was the highest in the third grade class a hospital and the lowest in the second grade class A hospital(P<0.017).Conclusions Compared with group 2003,the use rate of ARB in group 2007 was increased both in the third grade class A and the third grade class B hospitals,especially in the former.The decreased use of ACEI was due to the increased use of ARB,since the total use of ACEI or ARB beween group 2007 and 2003 were not significantly different.The use of diuretics was relative shortage,especially in group 2007 which in the third grade class A hospital.Compared with group 2003,the ratio of combinative administration in group 2007 was incresed significantly in the third grade class A hospital;The control rates for blood pressure were increased significantly in the third grade class B hospital ,which was because of the increased ratio of combinative administration.