Epidemiological Survey Of Blood Pressure Control And Target Organ Damage In Chinese Hypertension Outpatient

Hypertension is one of leading causes of death, the main purpose of the treatment of hypertension is to minimize the total risk of cardiovascular morbidity and mortality. As point out in national guidelines for the management of hypertension, in order to estimate the outpatient’s overall cardiovascular risk, draft the prevention and control programs, enhance the screening rate of the correlative factors and cardiovascular disease, enhance the control rate of blood pressure, improve the overall outcome of patients, the key point of the prevention and treatment of hypertension focus on then overall cardiovascular risk patients, including the level of blood pressure and other cardiovascular risk factors, and target organ damage and cardiovascular diseases.Part Ⅰ:Blood pressure control rate and its influencing factors in Chinese hypertension outpatients of different populationObjective To investigate the blood pressure control rate and the wawareness rate of risk factors, exploring the related determining factors of blood pressure control rate in different population of Chinese hypertension outpatients, providing the theory evidences for the risk management of hypertensive patients. Methods In this multicenter, cross-sectional epidemiological survey, from5Mar2011to5May2011, essential hypertensive outpatients aged18and over were recruited from125hospitals in29cities across China. The registered information including patient’s demographic, medical history;, blood pressure, clinical combining diseases and laboratory examination. Using multiple factors logistic regression model to analysis influence factors of blood pressure control. Results4100hypertensive patients were registered, including4subgroup:2191patients without other clinical disease,1413patients combining CHD(coronary heart disease),835patients combining DM(diabetes mellitus),301patients combining RD(renal disease),556patients combining more than one clinical deseases. The overall hypertensive patients blood pressure control rate is36.5%(the blood pressure control criterion defined:general population is<140/90mmHg, age equal or over65patients population is<150/90mmHg, combining DM or RD patients population is<130/80mmHg), the blood control rate of patient without other clinical disease is41.9%, combining CHD is36.0%, combining DM is13.5%, combing RD is13.3%. One-factor analysis showed that there was significant difference between the control group and the uncontrol grou in the following factors:patient’s demographic, medical history, blood pressure, clinical combining diseases and laboratory examination. The prevalence of clinical diseases associated with patients were CHD38.7%, DM23.0%, RD8.5%, strokes12.4%, peripheral arterial disease8.5%, terminal retinopathy4.7%, and the prevalence of clinical diseases of the control group is lower than the uncontrol group. Multiple factors logistic regression analysis suggested that lower blood pressure, older age, female, no smoking, without family history of heart disease, normal results of laboratory tests and patient’s individual type were the protect factors of blood pressure control. Conclusion The blood pressure control rate of outpatient is low, the protect factors of blood pressure control as follow:lower blood pressure, older age, female, no smoking, without family history of heart disease, normal results of laboratory tests, manual labour, follow-up patient. Advocate a healthy lifestyle, change the unhealthy habits, no-smoking, limit alcohol, proper physical exercise, screening of cardiovascular disease, reducing the blood pressure level, and enhance the blood pressure control rate. Part Ⅱ:The screening and wawareness of the related risk factors, the damage of target organ, combining clinical disease, and the survey of laboratory examination in clinical practiceObjective To evaluate the screening rate of hypertensive risk factors, target organ damage and combining clinical diseases, the wawareness of laboratory examination and the challenge in the clinical practice. Methods In this multicenter, cross-sectional epidemiological survey, the doctors, from125hospitals in29cities across China, registered essential hypertensive outpatients, aged18and over, informations, including outpatient’s demographic, the screening of the srelated risk factors, combining clinical diseases and laboratory examination, the wawarenss of laboratory examination and the challenge in clinical practice. Results4100hypertensive outpatients were registered, the high screening rate of the post-laboratory examination as follow:blood pressure59.7%, blood-lipid56.1%, serum creatinine50.3%, UA urinalysis40.7%, left ventricular hypertrophy (LVH)40.5%. the high screening rate of laboratory examination as follow:blood-lipid52.3%, LVH48.5%, hepatic47.5%, serum creatinine45.1%. The screening rate of combining clinical diseases as follow: CHV89.3%, DM88.7%, heart-failure88.0%, RD86.8%, stroke82.5%, peripheral arterial disease65.3%, terminal retinopathy66.3%. The wawareness of laboratory test, including LVH, microalbuminuria (MAU), sugar tolerance, were low, respectively39.8%,34.1%,31.7%, and the complicane rate were high, respectively84.0%,81.8%,80.1%. High fee, overelaborate test, patient’s uncomplicane, and availability were main challenge for laboratory examination in clinical practice. Conclusion The screening rate of hypertensive related factors was low, the based laboratory test was lower than60%and recommend laboratory test was10%. The screening rate of clinical diseases was high, the wawareness rate of laboratory test was low, but complicane was high. Unsophisticated and low fee laboratory tests were able to enhance the screening rate to trace out no-symptom sub-target damage, and diagnosised and treated early to improve the outcomes of the cardiovascular risk.