机构：[1]Department of Cardiology, The Second Affiliated Hospital of NanchangUniversity, Nanchang, China[2]Advanced Innovation Center for Food Nutritionand Human Health, College of Food Science and Nutritional Engineering,China Agricultural University, Beijing, China[3]National Clinical Research StudyCenter for Kidney Disease, State Key Laboratory of Organ Failure Research,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou,China[4]Department of Cardiology, Peking University First Hospital, Beijing,China[5]Department of Neurology, Guangdong Provincial Hospital of ChineseMedicine, Guangzhou, China[6]Prevention and Control Office of ChronicDisease in Rongcheng, Rongcheng, Shangdong, China[7]Disease Control andPrevention Center, Rongcheng, Shandong, China[8]People’s Hospital ofRongcheng, Rongcheng, Shandong, China[9]Health and Family PlanningCommission, Rongcheng, Shandong, China[10]Department of Pharmacy,Peking University First Hospital, Beijing, China[11]Health Management College,Anhui Medical University, Hefei, China[12]Institute of Biomedicine, AnhuiMedical University, Hefei, China[13]Centers for Metabolic Disease Research,Temple University School of Medicine, Philadelphia, PA, USA[14]Departmentof Cardiovascular, Neural and Metabolic Sciences, S Luca Hospital, Milan,Italy[15]Stroke Prevention and Atherosclerosis Research Centre, RobartsResearch Institute, Western University, London, ON, Canada[16]Department ofPopulation, Family and Reproductive Health, Johns Hopkins UniversityBloomberg School of Public Health, Baltimore, MA, USA[17]College ofIntegrated Traditional Chinese and Western Medicine, Anhui University ofChinese Medicine, Hefei, China
Background This study aimed to test the feasibility and titration methods used to achieve specific blood pressure (BP) control targets in hypertensive patients of rural China. Methods A randomized, controlled, open-label trial was conducted in Rongcheng, China. We enrolled 105 hypertensive participants aged over 60 years, and who had no history of stroke or cardiovascular disease. The patients were randomly assigned to one of three systolic-BP target groups: standard: 140 to < 150 mmHg; moderately intensive: 130 to < 140 mmHg; and intensive: < 130 mmHg. The patients were followed for 6 months. Discussion The optimal target for systolic blood pressure (SBP) lowering is still uncertain worldwide and such information is critically needed, especially in China. However, in China the rates of awareness, treatment and control are only 46.9%, 40.7%, and 15.3%, respectively. It is challenging to achieve BP control in the real world and it is very important to develop population-specific BP-control protocols that fully consider the population's characteristics, such as age, sex, socio-economic status, compliance with medication, education level, and lifestyle. This randomized trial showed the feasibility and safety of the titration protocol to achieve desirable SBP targets (< 150, < 140, and < 130 mmHg) in a sample of rural, Chinese hypertensive patients. The three BP target groups had similar baseline characteristics. After 6 months of treatment, the mean SBP measured at an office visit was 137.2 mmHg, 131.1 mmHg, and 124.2 mmHg, respectively, in the three groups. Home BP and central aortic BP measurements were also obtained. At 6 months, home BP measurements (2 h after drug administration) showed a mean SBP of 130.9 mmHg in the standard group, 124.9 mmHg in the moderately intensive group, and 119.7 mmHg in the intensive group. No serious adverse events were recorded over the 6-month study period. Rates of adverse events, including dry cough, palpitations, and arthralgia, were low and showed no significant differences between the three groups. This trial provided real-world experience and laid the foundation for a future, large-scale, BP target study.
基金：
Science and Technology Planning Project of Guangzhou, China [201707020010]; National Key Research and Development Program [2016YFC0903103, 2016YFC0904900, 2016YFE0205400, 2018ZX09739, 2018ZX09301034003]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81500233]; Major Projects of the Science and Technology Department, Jiangxi, China [20171BAB205008, 20161ACG70012]
第一作者机构：[1]Department of Cardiology, The Second Affiliated Hospital of NanchangUniversity, Nanchang, China
通讯作者：
推荐引用方式(GB/T 7714)：
Xiao Huang,Lishun Liu,Yun Song,et al.Achieving blood pressure control targets in hypertensive patients of rural China - a pilot randomized trial[J].TRIALS.2020,21(1):doi:10.1186/s13063-020-04368-1.
APA：
Xiao Huang,Lishun Liu,Yun Song,Lan Gao,Min Zhao...&the investigators of intensive BP control in China.(2020).Achieving blood pressure control targets in hypertensive patients of rural China - a pilot randomized trial.TRIALS,21,(1)
MLA：
Xiao Huang,et al."Achieving blood pressure control targets in hypertensive patients of rural China - a pilot randomized trial".TRIALS 21..1(2020)
