东阁街道2025年老年糖尿病合并高血压患者血糖、血压、血脂控制达标情况及用药方案分析

Glycemic, Blood Pressure and Lipid Control Rates and Medication Regimens in Elderly Patients with Comorbid Diabetes Mellitus and Hypertension in Dongge Subdistrict: A 2025 Analysis

摘要: 目的：分析辖区内2025年65岁及以上老年糖尿病合并高血压患者血糖血压血脂控制达标情况及用药方案，旨在为基层老年糖尿病合并高血压患者管理提供数据参考。方法：采用横断面研究设计，收集2025年5月14日至12月12日参加东阁街道65岁及以上老年人健康体检且系统内诊断为糖尿病合并高血压者的体检数据，采用SPSS25.0进行统计分析。结果：共纳入965名老年糖尿病合并高血压患者，男性374名(38.8%)，女性591名(61.2%)，平均年龄73.69 ± 5.24岁。血糖、血压、血脂达标率分别为：76.3% (736)，38.3% (370)，53.1% (512)。血糖达标率：城镇患者(80.7%)高于农村患者(71.2%)；血压达标率：≥80岁老年人(47.3%)高于65~79岁老年人(36.7%)，BMI < 24患者(44.2%)高于超重组(38.9%)、肥胖组(32.5%)；血脂达标率：城镇患者(56.9%)高于农村患者(48.7%)；差异均有统计学意义(P < 0.05)。主要降糖药物使用率为双胍类(76.5%)、钠–葡萄糖共转运蛋白2抑制剂(12.7%)、促泌剂(11.9%)、胰岛素(10.2%)；且血糖达标率随用药的种类增加而递减(0种至≥3种药物达标率分别为86.1%、77.5%、71.6%、56.0%，P = 0.005)。主要降压药物使用率为钙通道阻滞剂(46.7%)、血管紧张素II受体拮抗剂(43.0%)、利尿剂(12.4%)、β受体阻滞剂(10.4%)、血管紧张素转换酶抑制剂(5.0%)；用药0种至≥3种药物血压达标率分别为48.9%、37.9%、38.4%、33.3%，差异无统计学意义(P = 0.450)。结论：本辖区老年糖尿病合并高血压患者血糖控制良好且用药方案符合指南推荐；血压血脂达标率有很大提升空间，是当前管理的主要短板。基层需针对性优化降压调脂治疗，以全面提高共病患者代谢指标控制水平。

Abstract: Objective: To analyze the control rates of blood glucose, blood pressure, and blood lipids, as well as medication regimens in elderly patients aged 65 years and above with comorbid diabetes mellitus and hypertension in the jurisdiction in 2025, and aim to provide data reference for the management of such patients in primary care. Methods: A cross-sectional study design was adopted. Physical examination data of elderly people aged ≥ 65 years who participated in the health check-up in Dongge Subdistrict from May 14 to December 12, 2025 and were diagnosed with comorbid diabetes mellitus and hypertension in the system were collected. Statistical analysis was performed using SPSS25.0. Results: A total of 965 elderly patients with comorbid diabetes and hypertension were included, with 374 males (38.8%) and 591 females (61.2%). The mean age was 73.69 ± 5.24 years. The control rates for blood glucose, blood pressure, and blood lipids were 76.3% (736), 38.3% (370), and 53.1% (512), respectively. The blood glucose control rate was higher in urban patients (80.7%) than in rural patients (71.2%). The blood pressure control rate was higher in patients aged ≥80 years (47.3%) than in those aged 65~79 years (36.7%), and higher in patients with BMI < 24 (44.2%) than in overweight (38.9%) and obese (32.5%) groups. The blood lipid control rate was higher in urban patients (56.9%) than in rural patients (48.7%). All these differences were statistically significant (P < 0.05). The most used glucose-lowering drugs were biguanides (76.5%), sodium-glucose cotransporter 2 inhibitors (12.7%), secretagogues (11.9%), and insulin (10.2%). A decreasing trend in glycemic control was observed with an increasing number of glucose-lowering drugs (control rates: 86.1% for no medication, 77.5% for monotherapy, 71.6% for dual therapy, and 56.0% for ≥3 drugs; P = 0.005). The most used antihypertensive drugs were calcium channel blockers (46.7%), angiotensin II receptor blockers (43.0%), diuretics (12.4%), β-blockers (10.4%), and angiotensin-converting enzyme inhibitors (5.0%). Blood pressure control rates for no medication, monotherapy, dual therapy, and ≥3 drugs were 48.9%, 37.9%, 38.4%, and 33.3%, respectively, with no statistically significant difference (P = 0.450). Conclusion: In this jurisdiction, elderly patients with diabetes and hypertension demonstrate good blood glucose control, and their medication regimens align with guideline recommendations. However, substantial room for improvement remains in blood pressure and lipid control, representing a key gap in current management. Primary care settings should focus on targeted optimization of antihypertensive and lipid-lowering treatments to comprehensively enhance the control of metabolic indicators in this patient population.