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.
Whether or not when you look at the “Almost every other Divisions” the fresh new proportions off addressed people (55.9% having blood pressure and you may 62.4% to have lipid reducing pills) wasn’t the greatest (Extra file step one: Desk S1), the goal attainment prices to own BP (43.4%) (Most file dos: Desk S2), LDL-C (68%) (Dining table 2) and you can both BP and LDL-C (35.5%) (More file step 3: Dining table S3) was the greatest certainly one of every divisions examined. A potential reasons was one to in the “Other Departments” the fresh frequency out-of comorbidities and you can chance circumstances have been straight down and you can less patients needed seriously to has actually their BP and you can LDL-C around mmHg and you will dos.0 mmol/L, correspondingly.
Today’s data has numerous limits. Because it try a keen observational mix-sectional study, long-name outcomes couldn’t become analyzed. As well, what of one’s patients’ conformity was not obtained purposefully into the DYSIS-China. Which we could not get to know this new patients’ adherence so you’re able to cures accurately in the modern study. Furthermore, most of the people signed up for DYSIS-Asia got currently gotten at least 90 days antidyslipidemia medication (inclusion requirements datingranking.net/local-hookup/oshawa to own DYSIS-China) in addition to procedures price regarding statins inside diligent populace is of up to 89.7%. If DYSIS-Asia will have enrolled dyslipidemia sufferers repeatedly rather than eliminated customers in the place of past antidyslipidemia cures, the fresh statins’ cures price will have indeed come reduced than simply 89.7%, additionally the combined BP and LDL-C plans attainment rates worse as opposed to those in the current research.
Results
While the incidence of blood pressure levels for the Chinese dyslipidemia patients are large, a sizeable proportion out of people failed to get to the BP target, plus one another BP and you may LDL-C needs. An incomplete management program, improper monotherapy, incorrect diuretic prescription and you can bad therapy compliance will get make up the latest discouraging goal attainment pricing in Chinese clients having one another blood pressure levels and you can dyslipidemia. The content from your analysis clearly suggest that brand new organization regarding a sound government system for treating blood pressure and dyslipidemia is to getting an essential health care method within the China.
References
Wang Z, Chen Z, Zhang L, Wang X, Hao Grams, Zhang Z, Shao L, Tian Y, Dong Y, Zheng C, ainsi que al. Reputation out-of blood circulation pressure for the China: results from this new China hypertension survey, 2012-2015. Circulation. 2018;–56.
Zhang Meters, Deng Q, Wang L, Huang Z, Zhou M, Li Y, Zhao Z, Zhang Y, Wang L. Prevalence out of dyslipidemia and you can achievement off lower-thickness lipoprotein cholesterol goals during the Chinese people: a nationwide user survey regarding 163,641 adults. Int J Cardiol. 2018;–203.