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背景血压升高是中国人群脑卒中发病最重要的危险因素。降压治疗能显著减少脑卒中复发。目的了解中国非急性期缺血性脑卒中患者血压控制及降压药物使用情况,分析影响血压控制的因素。方法借助一项国际多中心临床试验在中国实施之际,对病史超过3月的缺血性脑卒中患者进行调查。利用电子问卷采集资料,进行统计描述和分析。结果 2007-06-2009-10期间,在中国14座城市共调查缺血性脑卒中患者6417名,平均年龄64岁。74%(4733)已知明确的高血压病史,其中20%未服用任何降压药物,仅21%(995)血压控制达标。血压控制率随服用降压药种类增多而逐渐增高(P<0.01)。合并糖尿病者血压控制率明显低于非糖尿病患者。合并心肌梗死或经皮冠状动脉介入治疗者血压控制率均高于无此病史者,服用他汀类药物或抗血小板药物的患者血压控制率高于不服药者(P<0.05)。1684例无高血压病史的患者中有60%血压升高。结论中国缺血性脑卒中患者血压控制情况距指南要求仍存在很大差距,加强其血压控制,将改善此类患者的预后。
Background High blood pressure is the most important risk factor for stroke in Chinese population. Antihypertensive treatment can significantly reduce the recurrence of stroke. Objective To understand the control of blood pressure and the use of antihypertensive drugs in patients with non-acute ischemic stroke in China and analyze the factors influencing blood pressure control. Methods With an international multicentre clinical trial in China, an investigation was performed on ischemic stroke patients with a history of more than 3 months. Using electronic questionnaires to collect data, statistical description and analysis. Results During 2007-06-2009-10, 6417 ischemic stroke patients were investigated in 14 Chinese cities, with an average age of 64 years. 74% (4733) have known a clear history of hypertension, 20% did not take any antihypertensive medication and only 21% (995) had blood pressure control up to the standard. Blood pressure control rate with the type of antihypertensive drugs increased gradually increased (P <0.01). Blood pressure control rate was significantly lower in diabetic patients than in non-diabetic patients. Blood pressure control rate in patients with myocardial infarction or percutaneous coronary intervention were higher than those without this history. Patients taking statins or antiplatelet drugs had higher rate of blood pressure control than those without medication (P <0.05). Sixty-six percent of 1,684 patients without a history of hypertension have elevated blood pressure. Conclusion There is still a long way to go from the guidelines to control blood pressure in patients with ischemic stroke. To strengthen their blood pressure control will improve the prognosis of these patients.