Kalavathy M C, Thankappan K R, Sarma P S, Vasan R S
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Kerala, India.
Natl Med J India. 2000 Jan-Feb;13(1):9-15.
Hypertension is one of the most important causes of cardiovascular morbidity and mortality in the elderly. With the increase in the number of elderly in India, hypertension is likely to emerge as an important public health problem.
We performed a cross-sectional survey of a random sample of 357 community-dwelling elderly individuals (191 women, 166 men; mean age 70 years) in Kerala. We measured blood pressure on all study participants using a standardized technique to assess the prevalence of hypertension. We compared the variations in prevalence, awareness, treatment and control of hypertension according to age, sex and place of residence of the subjects, and examined the socio-demographic correlates of hypertension using sex-specific multiple logistic regression.
The overall prevalence of hypertension in our sample was 51.8% (95% CI: 46.8%-56.8%), which did not vary with sex but increased with age. Fewer than half of the hypertensive subjects were aware of their condition or were on treatment, and only a quarter of the treated hypertensives achieved adequate control of blood pressure. Rural elderly subjects were especially less likely to be aware of, and on treatment for hypertension. Smoking status and rural residence (in men) and marital status (in women) were important correlates of hypertension.
Our findings emphasize the public health importance of hypertension in the elderly in Kerala at present, and point to a likely increase in burden of this problem in India in the near future. A National Hypertension Programme, targeted to meet the imminent public health challenge posed by hypertension seems warranted.
高血压是老年人心血管发病和死亡的最重要原因之一。随着印度老年人口数量的增加，高血压可能会成为一个重要的公共卫生问题。
我们对喀拉拉邦357名社区居住的老年人（191名女性，166名男性；平均年龄70岁）的随机样本进行了横断面调查。我们使用标准化技术测量了所有研究参与者的血压，以评估高血压的患病率。我们根据受试者的年龄、性别和居住地点比较了高血压患病率、知晓率、治疗率和控制率的差异，并使用性别特异性多元逻辑回归分析了高血压的社会人口学相关因素。
我们样本中高血压的总体患病率为51.8%（95%置信区间：46.8%-56.8%），其患病率不因性别而异，但随年龄增长而增加。不到一半的高血压患者知晓自己的病情或正在接受治疗，只有四分之一接受治疗的高血压患者血压得到了充分控制。农村老年受试者尤其不太可能知晓并接受高血压治疗。吸烟状况和农村居住（男性）以及婚姻状况（女性）是高血压的重要相关因素。
我们的研究结果强调了目前喀拉拉邦老年人高血压的公共卫生重要性，并指出在不久的将来印度这一问题的负担可能会增加。制定一项针对高血压带来的紧迫公共卫生挑战的国家高血压计划似乎是必要的。
