2022 年第 11 期 第 17 卷

75岁及以上心房颤动合并高血压病患者血压管理现状分析

Management status of blood pressure among patients 75 years or older with both atrial fibrillation and hypertension

作者：石继慧王海怡周文悦刘玮马晓桦刘畅马艾何柳马长生

英文作者：Shi Jihui Wang Haiyi Zhou Wenyue Liu Wei Ma Xiaohua Liu Chang Ma Ai He Liu Ma Changsheng

单位：首都医科大学附属北京安贞医院心内科，北京100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心房颤动；高血压；血压管理

英文关键词：Atrialfibrillation;Hypertension;Bloodpressuremanagement

• 摘要：

• 目的 分析75岁及以上心房颤动合并高血压病患者血压管理现状，为进一步加强患者健康管理提供依据。方法 纳入2011年8月至2020年12月参加中国心房颤动注册研究的75岁及以上心房颤动合并高血压病患者4 107例，收集一般人口学信息、收缩压、舒张压、合并疾病史、降压药物用药史，以评价高血压病知晓、治疗、控制现状以及降压治疗的影响因素。结果 在纳入分析的患者中，女性患者的高血压病知晓率高于男性［91.9%（1 945/2 117）比89.5%（1 782/1 990）］（P=0.010），降压药物治疗率也高于男性，但差异无统计学意义（P=0.075）。51.2%（2 104/4 107）的患者血压控制良好［男性51.9%（1 033/1 990）比女性50.6%（1 071/2 117），P=0.398］。未进行降压药物治疗患者血压控制良好率低于降压药物治疗者［47.1%（503/1 067）比52.7%（1 601/3 040）］（χ2=9.642，P=0.002），病死率高于降压药物治疗者，但组间差异无统计学意义［7.3（6.4，8.2）/100人年比6.4（6.0，6.9）/100人年］（Z=2.600，P=0.107）。多因素Logistic回归方法进行降压治疗的影响因素分析结果显示，较小的年龄、知晓高血压病史、有医疗保险、有心力衰竭和血管疾病病史与接受降压治疗呈正相关（均P<0.05）。结论 我国75岁及以上心房颤动合并高血压病患者血压管理现状较好，进一步加强血压监测、高血压筛查，有针对性地加强患者健康教育以提高治疗率和服药依从性，将有利于进一步改善患者预后。

• Objective To explore the management status of blood pressure in patients 75 years or older with both atrial fibrillation(AF) and hypertension, in order to provide evidence for further management. Methods Totally 4 107 patients 75 years or older with both AF and hypertension who participated in the China-AF registration study from August 2011 to December 2020 were enrolled. Demographic information, systolic pressure, diastolic pressure, combined disease history, and treatment with antihypertensive drugs were collected to evaluate status of hypertension awareness, treatment, control, and influencing factors for antihypertensive therapy. Results Among the patients included in the analysis, the awareness rate of hypertension in female was higher than that in male ［91.9%(1 945/2 117) vs 89.5%(1 782/1 990)］(P=0.010), and the rate of using antihypertensive drugs was also higher in females, but the difference was not statistically significant(P=0.075). Overall, 51.2%(2 104/4 107) of patients had well-controlled blood pressure［male 51.9%(1 033/1 990) vs female 50.6%(1 071/2 117), P=0.398］. Patients without antihypertensive drug treatment had a lower good rate of blood pressure control than those with antihypertensive drug treatment［47.1%(503/1 067) vs 52.7%(1 601/3 040)］(χ2=9.642, P=0.002); the fatality rate was higher than that of patients treated with antihypertensive drugs, but there was no significant difference between the two groups［7.3(6.4,8.2)/100 persons a year vs 6.4(6.0,6.9)/100 persons a year］(Z=2.600, P=0.107). Multivariate Logistic regression analysis showed that patients who were younger and aware of hypertension, had medical insurance, had history of heart failure and vascular disease were positively associated with taking antihypertensive therapy(all P<0.05). Conclusions The management status of blood pressure among patients 75 years or older with both AF and hypertension in China is satisfactory. Strategies of further blood pressure monitoring, hypertension screening, and strengthening health education will be helpful to further improve patients′ treatment rate, compliance and prognosis.