Jin Nuo Joan Tsang, Richard Woodman, Arduino A Mangoni
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引用次数: 0
Abstract
Background: Hypertension is a significant cardiovascular risk factor. While community hypertension is well studied, inpatient hypertension remains poorly understood with limited epidemiological data in Australian cohorts. We therefore investigated the prevalence and factors associated with inpatient systolic blood pressure (SBP) elevations, defined as SBP ≥140 mmHg using Australian data.
Methods: We conducted a retrospective cohort study on non-cardiac inpatients aged ≥65 admitted to general medical wards at Flinders Medical Centre, Adelaide (January-April in 2022-2024). Blood pressure recordings during hospital stay were extracted from electronic medical records. The primary endpoint was ≥10 SBP readings ≥140 mmHg, with secondary endpoints being at least one, two or three readings ≥140 mmHg.
Results: Among 753 eligible patients, 94.2% had at least one, 89.4% two, 85.7% three and 65.2% 10 SBP readings ≥140 mmHg. Independent factors positively associated with ≥10 elevations included age (years) (OR = 1.022, CI 1.00-1.04, P = 0.033), number of comorbidities (OR = 1.203, CI 1.06-1.35, P = 0.0026), length of stay (days) (OR = 1.041, CI 1.02-1.07, P = 0.002), antihypertensive use prior to admission (OR = 1.95, CI 1.26-3.02, P = 0.003) and use of calcium channel blockers (OR = 2.55, 1.53-4.25, P < 0.001). Whereas beta-blocker use (OR 0.593, CI 0.38-0.92, P = 0.020), history of coronary artery disease (OR = 0.59, CI 0.38-0.90, P = 0.015), chronic obstructive lung disease (OR = 0.46, CI 0.39-0.69, P < 0.001) and heart failure (OR = 0.43, CI 0.27-0.7, P < 0.001) were negatively associated.
Conclusions: This study provides first evidence of the epidemiology of inpatient SBP elevations in Australian inpatients and the associated factors. Further research should determine the clinical significance of these elevations and the impact of blood-pressure-lowering strategies in hospital settings.
背景：高血压是一个重要的心血管危险因素。虽然社区高血压研究得很好，但由于澳大利亚队列的流行病学数据有限，对住院高血压的了解仍然很少。因此，我们调查了住院患者收缩压（SBP）升高的患病率和相关因素，定义为收缩压≥140 mmHg。方法：我们对2022-2024年1 - 4月在阿德莱德弗林德斯医疗中心普通病房住院的年龄≥65岁的非心脏住院患者进行回顾性队列研究。从电子病历中提取住院期间的血压记录。主要终点为≥10个收缩压读数≥140 mmHg，次要终点为至少一个，两个或三个读数≥140 mmHg。结果：在753例符合条件的患者中，94.2%的患者至少有一次、89.4%的患者有2次、85.7%的患者有3次、65.2%的患者有10sbp读数≥140 mmHg。与≥10个血压升高呈正相关的独立因素包括年龄（岁）（OR = 1.022, CI 1.00-1.04, P = 0.033）、合并症数量（OR = 1.203, CI 1.06-1.35, P = 0.0026）、住院时间（天）（OR = 1.041, CI 1.02-1.07, P = 0.002）、入院前是否使用过降压药（OR = 1.95, CI 1.26-3.02, P = 0.003）、是否使用过钙通道阻滞剂（OR = 2.55, 1.53-4.25， P）。本研究首次提供了澳大利亚住院患者收缩压升高的流行病学及相关因素的证据。进一步的研究应该确定这些血压升高的临床意义和医院降压策略的影响。
期刊介绍：
The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.
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