接受抗凝治疗高血压合并心房颤动 患者的血压控制情况

Blood pressure control in anticoagulated patients with hypertension and atrial fibrillation

摘要:

目的 探讨接受抗凝治疗的高血压合并心房颤动（AF）患者的临床特点及血压（BP）控制率。 方法 选取2017 年1 月-2017 年6 月于北京市东城区第一人民医院就诊的≥ 18 岁非瓣膜性AF 患者，接受 维生素K 拮抗剂抗凝≥ 12 个月。根据有无合并高血压，将患者分为高血压AF 组和非高血压AF 组。患者入 组前进行CHADS2、CHA2DS2-VASc 和HAS-BLED 评分，检测国际标准化比率值。分析患者治疗后BP 控 制情况。结果 高血压AF 组患者年龄、CHADS2 评分、CHA2DS2-VASC 评分、HAS-BLED 评分、体重指 数和血脂异常发生率及糖尿病发生率均高于非高血压AF 组患者（P <0.05），随CHADS2 评分上升患者BP 控 制率呈增加趋势（P <0.05），0 ～ 40 岁、>40 ～ 50 岁、>50 ～ 60 岁、>60 ～ 70 岁、>70 ～ 80 岁及>80 ～ 100 岁年龄段高血压合并AF 患者BP 控制率呈增加趋势（P <0.05）。结论 >75% 高血压合并AF 患者实现了 BP 控制目标，并且这一比例在老年人中更高。其中超过三分之二的患者正在接受联合降压治疗。高血压合并 AF 患者BP 控制好于普通高血压人群。

Abstract:

Objective To determine the clinical profile and blood pressure (BP) control rates of anticoagulated patients with hypertension and atrial fibrillation (AF). Methods Patients with non-valvular AF aged 18 or older were enrolled from January to June 2017 and received vitamin K antagonist anticoagulation for at least 12 months. According to hypertension, they were divided into AF with hypertension group and AF without hypertension group. Before the patients were enrolled, CHADS2, CHA2DS2-VASC and HAS-BLED scores were performed, and INR values were tested. The control of blood pressure after treatment was analyzed. Results The age, CHADS2 score, CHA2DS2-VASC score, HAS-BLED score, body mass index, incidence of dyslipidemia and incidence of diabetes mellitus in AF with hypertension group were higher than those in AF without hypertension group (P < 0.05). BP control rate increased with CHADS2 score 1, 2, 3 and 4 (P < 0.05). BP control rate of hypertension patients with AF in the age groups of 0-40, >40-50, >50-60, >60-70, >70-80 and >80-100 years showed an increasing trend (P < 0.05). Conclusions More than 75% of hypertensive patients with AF achieve BP goals, and this rate is higher in elderly. More than two-thirds of patients were on combined therapy. BP control is better in AF patients than that in general hypertensive population.