目的：了解临床医师的高血压防治观念和对新版高血压防治指南的修订意见。方法2011年5月至10月在全国大、中城市随机选取89个城市医院（以三甲医院为主）的临床医师进行调查。共1570位临床医师参加了调查，数据完整的问卷1570份。问卷内容主要包括临床医师对正常高值血压的处理、心血管危险分层、特殊人群降压适宜的目标、生活方式改善的具体内容、传统降压药物的评价与推荐、固定剂量复方制剂的前景及应如何推荐等问题。结果83.6%的医师认为对正常高值血压合并多种心血管危险因素、糖尿病、心血管疾病或肾脏疾病的高危患者，在生活方式改善的基础上应及早进行药物治疗。92.7%的医师以心血管危险分层作为高血压治疗的依据，但78.3%的医师认为危险分层的内容需要简化。90.3%的医师认为糖尿病患者的目标血压是＜130/80 mmHg（1 mmHg=0.133 kPa），5.5%认为如能耐受，越低越好。53.9%的医师认为脑血管病后患者的目标血压应该是＜130/80 mmHg，41.1%认为是＜140/90 mmHg。64.6%的医师认为冠心病患者目标血压是＜130/80 mmHg，28.1%认为是＜140/90 mmHg。79.8%的医师认为慢性肾脏病患者的目标血压应该是＜130/80 mmHg，11.5%认为如能耐受越低越好。98.3%的医师认为，新版指南需要将减少钠盐摄入的措施具体化，92.0%的医师认为，新版指南需要将戒烟的措施具体化。69.9%的医师认为固定剂量复方制剂是降压药物的发展趋势。结论大部分医师认可并遵循2010版《中国高血压防治指南》，并对新版指南提出修改意见。%Objective To investigate the clinicians’ views on hypertension management and suggestions on revision of new-edition hypertension guidelines. Methods The clinicians were chosen from 89 hospitals (mainly third-class one-grade hospital) in Chinese large and middle-sized cities from May 2011 to Oct. 2011, and 1570 clinicians attended the survey and 1570 questionnaires with complete data were obtained. The content of the questionnaire included treatment of high-normal blood pressure (BP), cardiovascular risk stratification, right target of anti-hypertension in special people groups, lifestyle modification, reviews and recommendation of traditional antihypertensive drugs, and prospect and recommendation of fixed-dose compound preparations. Results Among 1570 clinicians, 83.6%of them suggested that high-risk patients with cardiovascular risk factors, and complicated diabetes, cardiovascular diseases or kidney diseases should be given timely drug therapies based on lifestyle modification, 92.7%took cardiovascular risk stratification as the basis of controlling hypertension, but 78.3%suggested that stratification content should be simplified. To diabetic patients, 90.3%of the clinicians suggested patient’s target BP was below 130/80 mmHg, and 5.5%of them thought the lower the better if patients could tolerate. To patients with cerebrovascular diseases, 53.9%of the clinicians suggested patient’s target BP was below 130/80 mmHg, and 41.1%of them suggested below 140/90 mmHg. To the patients with coronary heart disease, 64.6%of the clinicians suggested patient’s target BP was below 130/80 mmHg, and 28.1%of them suggested below 140/90 mmHg. To the patients with chronic kidney disease, 79.8%of the clinicians suggested patient’s target BP was below 130/80 mmHg, and 11.5%of them thought the lower the better. To the new-edition guideline, 98.3%of the clinicians suggested to materialize the measures of reducing salt uptake, and 92.0%of them suggested to materialize the measures of abandoning smoking. The fixed-dose compound preparations were considered by 69.9%of the clinicians as a development tendency of anti-hypertension drug. Conclusion Most of the clinicians have accepted the Hypertension Prevention and Cure Guideline of China (2010), and put forward revision proposals to the new-edition guideline.
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