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Objective To evaluate the effect of intensive hypertension management model for patients with uncontrolled blood pressure in community.Methods Three hundred and seven hypertensive patients,whose blood pressure was not controlled with administration of two or more kinds of antihypertensive drugs,entered in the intensive management program from May 2015 to December 2017.Using calcium channel blockers,angiotensin converting enzyme inhibitors or angiotensin receptor blockers and diuretic as the primary scheme,the medication was adjusted by general practitioners under the guidance of specialists in tertiary hospitals.The "seamless" two-way referral between community and tertiary hospitals was implemented,and the blood pressure control,medication and adverse effects were analyzed.Results Among 307 patients,157 were males (51.1％) and the mean age was (65.0±8.6) years.There were 246 (80.0％)patients with moderate and severe hypertension 44 (14.3％) patients complicated with diabetes,and 63(20.5％) patients having comorbidities,and the patients with high risk or extremely high-risk accounted for 85.0％ (261/307).Through (3.97± 1.21) months (1-6 months) intensive management,systolic blood pressure decreased from (167.56±16.73)mmHg(1 mmHg=0.133 kPa) in the baseline to (132.79±11.24)mmHg (t=33.34,P＜0.01),and diastolic blood pressure from (95.34± 12.59) mmHg to(79.11 ±7.85) mmHg (t=23.67,P＜0.01),blood pressure control rate was 75.6％(232/307).No serious adverse reactions occurred.During the period 42 patients were referral to hospital through green channel with a referral rate of 13.7％,and six patients were diagnosed as secondary hypertension.Angiotensin receptor antagonists and calcium antagonists were the main antihypertensive drugs.After intensive management patients taking three or more antihypertensive drugs increased by 158 and those taking diuretics increased by 116.Conclusions The intensive management model is effective in patients with uncontrolled blood pressure in community.Early use of C+A,A+D,and A+C+D treatment schemes for uncontrolled patients in the community can improve the rate of reaching the target and is safe.
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Background Hypertension and dyslipidemia are the 2 important risk factors of cardiovascular affecting the prognosis of cardiovascular disease. However paucity data of characteristics of lipid metabolism and prognosis of cardiovascular diseases in high-risk groups with hypertension are available. Objective To analyze the lipid metabolism level and the relevant risk factors of inpatients with essential hypertension (EH) from 2000 to 2007. Methods Retrospective study was performed based on the clinical characteristic and the relationship between different kinds of hyperlipidemia and target organ damages in inpatient with EH. Results For the level of triglyceride (TG) and the prevalence of hypertriglyceridemia,males(n=3056) were significantly higher than females(n=1932)(P
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<p><b>OBJECTIVE</b>To verify the linkage of the candidate regions identified in a previous study (markers D2S168, D2S151, D2S142 on chromosome 2) with hypertension in Chinese families.</p><p><b>METHODS</b>A genetic linkage study focused on chromosome 2 was performed on 240 Chinese families containing 856 patients with essential hypertension. A total of 1080 individuals were genotyped using 9 highly polymorphic microsatellite markers around the candidate regions on chromosome 2 with an average spacing of 5 cM. Non-parametric linkage (NPL), parametric linkage analysis and transmission-disequilibrium test (TDT) with the GENEHUNTER software were used to assess evidence for linkage.</p><p><b>RESULTS</b>Linkage of a region on chromosome 2 around D2S151 and D2S142 with hypertension was confirmed by different statistical methods (NPL, LOD score and TDT). However, the linkage of D2S168 could not be replicated in this extension study.</p><p><b>CONCLUSIONS</b>The data suggest that a region on chromosome 2 at or near the loci of D2S142 and D2S151 may harbor genes responsible for the development of essential hypertension in Chinese.</p>
Subject(s)
Female , Humans , Male , Alleles , China , Chromosomes, Human, Pair 2 , Genetics , Family Health , Gene Frequency , Genetic Linkage , Hypertension , Genetics , Linkage Disequilibrium , Microsatellite RepeatsABSTRACT
<p><b>OBJECTIVE</b>To investigate the genetic linkage between several cytokine and cytokine-related receptor gene loci and essential hypertension (EH) in Chinese.</p><p><b>METHODS</b>Linkage between seven genetic markers and EH in 95 Chinese nuclear families with EH (including 477 subjects) was analyzed using a technique of fluorescence-based gene scan with DNA short tandem repeat loci. These markers were selected from the chromosomal regions nearby eight cytokines and their receptor genes. The two-point non-parametric linkage analysis (NPL), maximum Lod score and transmission/disequilibrium test (TDT) with GENEHUNTER software package were used in this study.</p><p><b>RESULTS</b>Result of TDT showed significant transmission disequilibrium between D14S61 and EH (Chi square 14.29,P=0.00016) although NPL and Lod score revealed no significant linkage (Z=0.78, P>0.05 and Lod score =0.72 respectively) at this locus. No linkage between other loci typed and EH was found by the three genetic analysis methods (P>0.05 or Lod score<-1).</p><p><b>CONCLUSION</b>Alleles at D14S61 were of significant transmission disequilibrium in affected siblings. Transforming growth factor beta 3 is 0.1 cM away from D14S61, which suggests that the relationship between genes at or near this regions and EH needs to be further explored.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Alleles , Blood Glucose , Metabolism , Blood Pressure , Physiology , Body Mass Index , China , Cholesterol , Blood , Cholesterol, HDL , Blood , Cholesterol, LDL , Blood , Cytokines , Genetics , DNA , Genetics , Family Health , Genetic Linkage , Hypertension , Blood , Genetics , Linkage Disequilibrium , Lod Score , Microsatellite Repeats , Receptors, Cytokine , Genetics , Triglycerides , BloodABSTRACT
Objective To study the relationship between parathyroid hormone(PTH)level and central arterial stiffness in patients with high risk of coronary artery disease(CAD) and preserved renal function.Methods Seventy-seven patients with at least one risk factor of coronary artery disease (CAD) were divided into increased arterial stiffness group(n=35) and control group(n=42),based on whether the noninvasive pulse wave analysis index of the central pulse pressure(CPP) was higher than 40mmHg or not.Coronary artery angiography was performed in all cases.Serum intact PTH,calcium,phosphor,and highly sensitive C reactive protein (hsCRP) was assessed by radioimmunoassay.Coronary angiography was also performed.Results The patients in increased arterial stiffness group were elder and had higher serum uric acid compared with those in the control group.Forty-four patients were confirmed to have CAD; CAD patients in the stiffness group (n=23) had significantly higher serum iPTH level compared with those in the control group(n=21) (P40 mmHg)after adjustment for age,BMI,hs-CRP,and male gender.Conclusion CAD patients with increased central arterial stiffness and preserved renal function have higher serum PTH level.The serum PTH level is positively correlated with central arterial stiffness,and is the independent risk factor for increased arterial stiffness.