| Objective:To explore the current status of anti-hypertensives and blood pressure control in hospitalized hypertensive patients in the First Affiliated Hospital of Nanchang University after being certified by the Hypertension Compliance Center,and analyze the related influencing factors.Methods:The basic information,comorbidities,types and quantities of anti-hypertensives,blood pressure control level and whether it was up to standard were collected on hypertensive patients from January 2021 to December 2021 admitted to the Department of Cardiovascular Medicine,the First Affiliated Hospital of Nanchang University.Comparing the current status of anti-hypertensives and blood pressure control with relevant domestic studies,and analyzed the factors affecting the use of anti-hypertensives and blood pressure control by binary logistic and multiple linear regression models.Results:A total of 1043 hypertensive patients who met the criteria were included in the study,including 680 males(65.20%)and 363 females(34.80%),with an average age of 63.0±14.9 years old,and there were 401 patients over 70 years old,accounting for the highest proportion(40.27%).Among the comorbidities,coronary heart disease accounted for the highest proportion(37.01%),followed by diabetes accounting for23.87%,chronic kidney disease accounting for 17.07%,heart failure accounting for15.24%,peripheral vascular disease accounting for 9.78%,stroke/TIA and atrial fibrillation accounting for 9.01%.Among the overall medication,CCB usage rate was the highest at 54.65%,followed by β-blockers at 33.37%,ACEI/ARB/ARNI at24.92%,and diuretics at 13.90%;patients with combined anti-hypertensives accounted for 61.55%,patients with single anti-hypertensives accounted for 38.45%,among which the usage rate from high to low was CCB(54.61%),ACEI/ARB/ARNI(21.70%),β-blockers(20.70%),diuretic(2.24%).The analysis of the influencing factors of single anti-hypertensives and combined anti-hypertensives by binary logistic regression showed that hypertensive patients with high BMI,high serum potassium,high hypertension grade,stroke/TIA and diabetes tended to choose combined anti-hypertensives,hypertensive patients with older age,high blood sodium,high serum creatinine,coronary heart disease,atrial fibrillation and peripheral vascular disease were more inclined to choose single anti-hypertensives.Among the patients with combined anti-hypertensives,patients with single-pill combination(SPC)accounted for 39.56%,the highest proportion of patients with dual anti-hypertensives was 56.23%,followed by patients with triple anti-hypertensives accounting for29.28%,patients with quadruple anti-hypertensives or more accounting for 14.49%.The analysis of the influencing factors of using SPC by binary logistic regression showed that patients with high school education or above,high blood sodium,high blood potassium,stroke/TIA and heart failure were more inclined to use SPC.The analysis of the influencing factors of the select to types of anti-hypertensives by multiple linear regression showed that male,BMI,drinking,atrial fibrillation,heart failure,diabetes and serum creatinine were positively correlated with the number of anti-hypertensives types,age and serum potassium were negatively correlated.The blood pressure control compliance rate of hypertensive patients was 82.36%.The analysis of the influencing factors of blood pressure control effect by binary logistic regression showed that exercise,more types of anti-hypertensives,chronic kidney disease and SPC promoted blood pressure compliance.Patients with older age,heart failure and high blood sodium were more difficult to reach the target.Conclusions:The overall and single anti-hypertensives treatment in our hospital are mainly CCB,which is consistent with other regions in China;the use rate of combined antihypertensives and SPC need to be improved,especially SPC is the first-line antihypertensives recommended by domestic and foreign experts and the latest guidelines.Analysis of the influencing factors of the use of anti-hypertensives: patients with older age,high blood sodium,high serum creatinine,coronary heart disease,atrial fibrillation and peripheral vascular disease tend to choose single anti-hypertensives;patients with high BMI,high serum potassium,high hypertension grade,stroke/TIA and diabetes are more inclined to choose combined anti-hypertensives;patients with high school education or above,high blood sodium,high blood potassium,stroke/TIA and heart failure are more likely to use SPC;male,BMI,drinking,atrial fibrillation,heart failure,diabetes and serum creatinine are positively correlated with the types of anti-hypertensives,while age and serum potassium are negatively correlated.The blood pressure control compliance rate of hypertensive patients is significantly higher than the domestic average level,which affirms the significance of the establishment of the Hypertension Compliance Center in the First Affiliated Hospital of Nanchang University;the analysis of the influencing factors of blood pressure control effect shows that exercise,more types of anti-hypertensive drugs,chronic kidney disease and SPC promote blood pressure to reach the target,patients with older age,heart failure and high blood sodium have worse blood pressure control. |
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