Amar J, Vernier I, Ruidavets J B, Ferrieres J, Salvador M, Chamontin B
Service de médecine interne et d'hypertension artérielle, CHU Purpan, Toulouse.
Arch Mal Coeur Vaiss. 1999 Aug;92(8):945-8.
WHO management plan for mild hypertension recommends to take into account total cardiovascular risk in the decision treatment making process. However, despite a lower coronary risk in women than in men, hypertension awareness, treatment and control were higher in women than in men. This study was designed to evaluate the relationships between sex, coronary risk, awareness and treatment of hypertension in Haute-Garonne a south western French region.
1,160 subjects aged 35-64, 600 men, were recruited between 1994 and 1996 by the Toulouse MONICA center. Subjects were selected by stratified randomization on age and size of home area. For each patient a score of coronary risk based on Framingham equation was calculated.
157 treated hypertensives (HT), 73 men and 84 women (G1) whom 046 adequately treated were identified, 16 men and 30 women. 60 known but untreated HT, 38 men and 22 women (G2), 171 newly diagnosed HT, 115 men and 53 women (G3). In men, the coronary risk score was higher in treated hypertensives compared with G2 and G3 (G1: 19.19 +/- 5.77 vs G2: 16.71 +/- 6.12 vs G3: 17.42 +/- 5.65) while no significant difference was observed in BP between these three groups (G1: 150.73 +/- 18.6/88.57 +/- 10.81 vs G2: 151.97 +/- 10.59/89.73 +/- 8.04 vs G3: 146.68 +/- 12.14/90.05 +/- 9.19) were observed between these three groups. In treated men, patients were older, total cholesterol was lower, intake of hypolipidemic drugs and diabetes were more prevalent than in the other two groups. In women, coronary risk score were not significantly different between the three groups.
This study confirms the higher rate of awareness, treatment and control of hypertension in women. In men, treated hypertensives are at higher coronary risk than untreated and/or unawareness hypertensives: an improvement of hypertension control appears the prerequisite to decrease absolute cardiovascular risk in this group. In women, treated patients have a risk close to the level observed in untreated hypertensives.
世界卫生组织轻度高血压管理计划建议在决策治疗过程中考虑总体心血管风险。然而，尽管女性的冠心病风险低于男性，但女性的高血压知晓率、治疗率和控制率却高于男性。本研究旨在评估法国西南部上加龙省性别、冠心病风险、高血压知晓率与治疗之间的关系。
图卢兹莫尼卡中心在1994年至1996年期间招募了1160名35 - 64岁的受试者，其中600名男性。受试者通过按年龄和居住地区规模进行分层随机抽样选取。为每位患者根据弗雷明汉方程计算冠心病风险评分。
确定了157例接受治疗的高血压患者（HT），其中73名男性和84名女性（G1组），其中46例得到充分治疗，16名男性和30名女性。60例已知但未治疗的高血压患者，38名男性和22名女性（G2组），171例新诊断的高血压患者，115名男性和53名女性（G3组）。在男性中，接受治疗的高血压患者的冠心病风险评分高于G2组和G3组（G1组：19.19±5.77 vs G2组：16.71±6.12 vs G3组：17.42±5.65），而这三组之间的血压无显著差异（G1组：150.73±18.6/88.57±10.81 vs G2组：151.97±10.59/89.73±8.04 vs G3组：146.68±12.14/90.05±9.19）。在接受治疗的男性中，患者年龄更大，总胆固醇更低，服用降脂药物和患糖尿病的情况比其他两组更普遍。在女性中，三组之间的冠心病风险评分无显著差异。
本研究证实女性高血压的知晓率、治疗率和控制率更高。在男性中，接受治疗的高血压患者比未治疗和/或未意识到自己患高血压的患者有更高的冠心病风险：改善高血压控制似乎是降低该组绝对心血管风险的前提条件。在女性中，接受治疗的患者的风险接近未治疗的高血压患者所观察到的水平。
