J Hypertens:心内科高血压患者有1/3患糖尿病,内分泌科糖尿病患者有2/3合并高血压

2016-12-28 卢芳 中国循环杂志

由上海瑞金医院王继光等进行的研究显示,高血压和糖尿病共患率较高,但对于心内科和内分泌科而言,前来就诊的二病并存患者,前者控糖药物使用不够,后者降压药物使用不足,血压血糖均达标者两科均不过半。 研究者指出,或许高血压和糖尿病联合管理平台有助于提高和改善当前救治状况。 研究显示,在心内科就诊的高血压患者约有1/3同时罹患糖尿病,而在内分泌科就诊的糖尿病患者中则有约2/3合并高血压。

由上海瑞金医院王继光等进行的研究显示,高血压糖尿病共患率较高,但对于心内科和内分泌科而言,前来就诊的二病并存患者,前者控糖药物使用不够,后者降压药物使用不足,血压血糖均达标者两科均不过半。

 

研究者指出,或许高血压糖尿病联合管理平台有助于提高和改善当前救治状况。

 

研究显示,在心内科就诊的高血压患者约有1/3同时罹患糖尿病,而在内分泌科就诊的糖尿病患者中则有约2/3合并高血压。总体受试者中,有45.3%二病共患(图1)。

 


在心内科和内分泌科高血压和糖尿病共患流行状况


 

在高血压管理方面,当前无论是高血压临床管理指南,还是糖尿病指南相关推荐,均指出,对于二病共患者,要严格控制血压,并且肾素-血管紧张素系统抑制类降压药为一线降压药。

 

但研究者进一步分析发现,在内分泌科,降糖时联合应用降压药治疗(25.1% vs 51.5%),以及应用肾素-血管紧张素系统抑制类降压药(46.7% vs 56.9%)比例均低于心内科。

 

而在心内科,对于二病共存患者,降压时联合应用口服降糖药或胰岛素使用比例低于内分泌科(4.2% vs 21.2%)。

 

不过,比较两类科室,不论是140/90 mmHg还是130/80 mmHg为降压目标,还是糖化血红蛋白以7.0%6.5%为降糖目标,二病共患者其血压、血糖控制率均无统计学差异。

 

糖尿病和高血压共患时,多会增加肾病风险。研究也显示,二病共患者其蛋白尿罹患率为23.3%,而仅有高血压者为12.6%,仅有糖尿病者为15.9%。而且,蛋白尿随着血压、血糖的升高而患病率也升高。研究者认为,这支持二病共患者130/80 mmHg为降压目标更适宜。

 

这项横断面多中心研究共纳入2459例就诊者,包括在心内科就诊的1291例高血压患者,和在内分泌科就诊的1168例糖尿病患者。

 

原始出处:


Song J, Sheng CS, Huang QF, et al. Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians: a China registry. J Hypertens, 2016, 34: 1648-53.

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    2017-11-21 feather89
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    2016-12-28 雾夜芭蕾

    内分泌及不合格的相互交叉性

    0

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