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.
Even though in the “Other Divisions” the fresh proportions from addressed customers (55.9% for blood pressure and you can 62.4% to have lipid reducing medicines) wasn’t the best (Extra document step 1: Table S1), the target attainment prices to own BP (43.4%) (Most document dos: Table S2), LDL-C (68%) (Table 2) and both BP and you can LDL-C (thirty five.5%) (Most file 3: Desk S3) was indeed the best one of the divisions checked-out. A possible explanation would-be one into the “Other Departments” the newest incidence out-of comorbidities and you will risk circumstances was in fact all the way down and you will less customers necessary to provides their BP and you will LDL-C significantly less than mmHg and dos.0 mmol/L, respectively.
The current study has several restrictions. Whilst was an enthusiastic observational cross-sectional investigation, long-identity consequences could not become assessed. On the other hand, every piece of information of your patients’ compliance was not built-up purposefully in the DYSIS-Asia. And this we can not get to know the latest patients’ adherence to help you cures precisely in today’s analysis. Additionally, all the customers subscribed to DYSIS-China had already acquired no less than 3 months antidyslipidemia therapy (addition criteria to own DYSIS-China) while the medication speed away from statins within patient people is as high as 89.7%. If DYSIS-China would have signed up dyslipidemia subjects repeatedly rather than removed people rather than earlier in the day antidyslipidemia treatment, this new statins’ cures speed could have indeed become reduced than 89.7%, while the joint BP and you can LDL-C goals attainment rates bad as opposed to those in the present analysis.
Conclusions
While the frequency from blood pressure level in the Chinese dyslipidemia clients is actually higher, a significant proportion regarding people didn’t reach the BP address, together with both BP and you may LDL-C aim. An incomplete administration program, poor monotherapy, inappropriate diuretic pills and you may terrible cures conformity will get account fully for the newest discouraging goal attainment prices for the Chinese customers having both hypertension and you will dyslipidemia. The information and knowledge from your analysis demonstrably recommend that the brand new facilities out of a sound management system for the treatment of blood circulation pressure and you will dyslipidemia is always to become an essential medical care method in China.
Recommendations
Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, Shao L, Tian Y, Dong Y, Zheng C, ainsi que al. Reputation off blood pressure levels inside the Asia: comes from brand new Asia blood pressure level questionnaire, 2012-2015. Stream. 2018;–56.
Zhang M, Deng Q, Wang L, Huang Z, ios hookup apps Zhou M, Li Y, Zhao Z, Zhang Y, Wang L. Frequency off dyslipidemia and you will completion out-of reasonable-occurrence lipoprotein cholesterol levels purpose in Chinese adults: a nationwide member questionnaire out-of 163,641 grownups. Int J Cardiol. 2018;–203.