Our multivariate logistic regression analysis showed that obesity, diabetes, coronary heart disease, cerebrovascular disease and chronic kidney disease were independent risk factors associated with BP target attainment failure. 9%) in our hypertensive dyslipidemia patients. For those with diabetes, CHD and/or CKD, the lower BP target (< mmHg) in the 2010 Chinese Hypertension Guideline may partially account for the disappointing BP attainment rates. However, the BP target rate in patients with obesity or cerebrovascular disease were also very low, though these patients shared the same BP target value (SBP/DBP < mmHg) as uncomplicated hypertensives. Moreover, the analysis of dyslipidemia management in DYSIS-China also revealed that diabetes was a strong predictor of failure in attaining LDL-C and non-HDL-C goals . Zhao's result are in accordance with the findings of our multivariate logistic regression analysis, which showed that diabetes was an independent risk factor for not achieving BP and combined BP and LDL-C targets. Therefore, besides the stricter BP target value for these comorbidities, there must be other reasons (vide supra) that may account for the low BP target attainment rates. Further measures should be taken to spread the recommendations of our guidelines in order to improve BP and LDL-C control rate in patients with comorbidities. The doctors in endocrine or neurology departments should focus more on the control of BP and LDL-C in their patients, though the circumstances in other departments were also not optimal in our study.
No matter if inside “Other Departments” the fresh proportions away from handled patients (55.9% getting blood circulation pressure and you may 62.4% to have lipid minimizing pills) was not the highest (More document 1: Dining table S1), the goal attainment cost for BP (43.4%) (A lot more document dos: Dining table S2), LDL-C (68%) (Table dos) and you will one another BP and you can LDL-C (35.5%) (Extra document 3: Table S3) was in fact the best one of the divisions looked at. A potential cause might possibly be that within the “Other Departments” the brand new frequency off comorbidities and you will risk situations was straight down and you will less people needed to possess their BP and you may LDL-C below mmHg and you will 2.0 mmol/L, respectively.
The present research has numerous limits. Because is a keen observational mix-sectional investigation, long-title outcomes could not feel reviewed. As well, all the details of patients’ compliance wasn’t compiled intentionally during the DYSIS-Asia. And this we are able to perhaps not get acquainted with the brand new patients’ adherence so you can medication truthfully in the modern investigation. In addition, all patients enrolled in DYSIS-Asia got already received about 90 days antidyslipidemia procedures (addition conditions to own DYSIS-China) while the therapy rates off statins in this patient population try all the way to 89.7%. When the DYSIS-Asia might have enrolled dyslipidemia subjects repeatedly rather than got rid of patients in the place of previous antidyslipidemia cures, the new statins’ therapy rate would have indeed already been dramatically reduced than 89.7%, and combined BP and LDL-C plans attainment prices even worse than others in the present studies.
Conclusions
Even though the prevalence away from blood pressure for the Chinese dyslipidemia patients is actually large, a sizeable ratio from patients failed to achieve the BP target, plus one another BP and you can LDL-C goals. An unfinished management program, inappropriate monotherapy, inappropriate diuretic medication and terrible cures compliance can get take into account brand new disappointing mission attainment costs within the Chinese clients that have both blood pressure and dyslipidemia. The information from our analysis demonstrably recommend that the new establishment out-of a sound management program for the treatment of hypertension and you will dyslipidemia is getting an essential medical care means inside the China.
Sources
Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, Shao L, Tian Y, Dong Y, Zheng C, ainsi que al. Status from blood pressure levels during the China: results from the fresh China blood pressure survey, 2012-2015. Stream. 2018;–56.
Zhang Yards, Deng Q, Wang L, Huang Z, Zhou Yards, Li Y, Zhao Z, Zhang Y, Wang L. Incidence out-of dyslipidemia and end out of reduced-occurrence lipoprotein cholesterol levels targets into the Chinese people: a nationally representative survey from 163,641 people. Int J Cardiol. 2018;–203.