Physician Practice Patterns in the Treatment of Isolated Systolic Hypertension in a Primary Care Setting
作者:Jeff Borenstein、Joanna L. Whyte、Enkhe Badamgarav、Delia Vogel、Stephen Deutsch、Scott Weingarten、Pablo Lapuerta
DOI:10.1111/j.1524-6175.2001.01218.x
日期:2002.3
The authors evaluated the treatment of isolated systolic hypertension based on medical record review of charts between 1998 and 1999 in a multispecialty physician practice group. Two age‐stratified random samples of ambulatory medical records were examined (393 patients aged ≥65 years and 251 patients aged 50–64 years). The samples corresponded to the practices of 35 primary care physicians who were surveyed about their hypertension care. Isolated systolic hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure <90 mm Hg. Results showed that isolated systolic hypertension represented 76% and 45% of uncontrolled blood pressure in the older and middle‐aged samples, respectively. Isolated systolic hypertension was often undiagnosed and untreated. Physicians reported treatment thresholds and goals that were significantly less aggressive for their patients ≥65 years of age. Physician awareness and treatment of isolated systolic hypertension have not yet caught up with consensus guidelines, and older patients may be affected most by this gap.
作者通过审查 1998 年至 1999 年间一家多专科医师实践团体的病历,评估了孤立性收缩期高血压的治疗方法。研究者检查了两个按年龄分层的随机样本的门诊病历(393 名 ≥65 岁患者和 251 名 50-64 岁患者)。这些样本对应于 35 名初级保健医生的实践,这些医生接受了关于其高血压护理的调查。孤立性收缩期高血压被定义为收缩压 ≥140 mm Hg 且舒张压 <90 mm Hg。结果显示,在老年样本和中年样本中,孤立性收缩期高血压分别占未控制血压的 76% 和 45%。孤立性收缩期高血压通常未被诊断和治疗。医生报告称,他们对 ≥65 岁患者的治疗阈值和目标明显不那么积极。医生对孤立性收缩期高血压的认识和治疗尚未赶上共识指南,老年患者可能受到这一差距的最大影响。