당뇨병이 동반된 고혈압 환자에 대한 항고혈압제 선택 -포항？경주 1차 의료 연구망을 중심으로-
Selection of Antihypertensive Drugs in Hypertensive Patients with Diabetes Mellitus -In Pohang-Gyeongju Primary Care Research Network-
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연구배경: 당뇨병이 동반된 고혈압 환자에 대한 항고혈압제는 angiotensin converting enzyme inhibitor 또는 angiotensin II type 1 receptor blocker가 일차선택약제로 권고되고 있다. 그러나 지역사회 개원 가정의가 당뇨병이 동반된 고혈압 환자에게 처방하는 항고혈압제에 관한 연구는 없다. 방법: 2004년도 12월 한 달 동안 10명의 개원 가정의가 당뇨병이 동반된 고혈압 환자 169명에게 투약한 처방전을 분석하였다. 분석 후 직접 10명의 개원 가정의를 방문하여 약물의 선택에 영향을 미친 요인에 대해 조사하였다. 결과: 항고혈압제 처방은 총 21가지였다. Calcium channel blocker 단독요법이 55예(32.5%)로 가장 많았다. Angiotensin converting enzyme inhibitor 단독요법이 20예(11.8%), Angiotensin II type 1 receptor blocker 단독요법이 16예(9.5%)였다. Angiotensin II type 1 receptor blocker 사용빈도가 낮은 이유로는 불충분한 강압효과가 7명, 부족한 약품 정보 5명, 약제 변경에 대한 환자의 저항감 4명, 비싼 약값 4명이었다. 결론: 당뇨병이 동반된 고혈압 환자에 대한 항고혈압제로서 angiotensin converting enzyme inhibitor 또는 angiotensin II type 1 receptor blocker의 선택이 적었다. 당뇨병이 동반된 고혈압 환자에서 합병증 발생을 줄이기 위하여 angiotensin converting enzyme inhibitor 또는 angiotensin II type 1 receptor blocker가 더 많이 선택되어야 하겠다.
Abstract
Selection of Antihypertensive Drugs in Hypertensive Patients with Diabetes Mellitus -In Pohang-Gyeongju Primary Care Research Network-Chul Won Jang, M.D., Ki Hoon Ha, M.D., Nak Jin Sung, M.D., Dong Wook Lee, M.D., Kyung Rae Cho, M.D.*, Sook Heong Jung, M.D.*, Seok Choi, M.D.*, Jae Man Ki, M.D.*, Sung Woo Kim, M.D.*, Kyung Ja Choi, M.D.*, Dong Ik Kim, M.D.*, Joon Seok Song, M.D.*, Young Kyu Choi, M.D.*, Hee Nam Song, M.D.*, Ki Heum Park M.D.†
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