Tedesco M A, Di Salvo G, Caputo S, Natale F, Ratti G, Iarussi D, Iacono A
Medical Surgical Department of Cardio-Thoracic Sciences, Second University of Naples, Naples, Italy.
J Hum Hypertens. 2001 Oct;15(10):727-31. doi: 10.1038/sj.jhh.1001249.
This is the first European study that has evaluated educational level in a large sample of hypertensive outpatients. We established the educational level of the hypertensive outpatients in our unit, and determined whether the awareness of hypertension and its organ damage was education-related. We analysed data from 812 consecutive outpatients (378 men, mean age 50 +/- 10 years) with essential stage I-II hypertension. Subjects were subdivided into two categories: group A subjects were highly educated; group B subjects had a little education. Data were compared with educational level from the 1991 population census for the Campania region (ISTAT data) and with 200 type 2 diabetes patients (96 men, mean age 51 +/- 9 years) from the nearest diabetes unit. For each hypertensive patient we considered clinical, echocardiographic and biochemical parameters. Data from the last census showed a high percentage (80%) of subjects with low education. The percentage of type 2 diabetic patients with little education was high (190 patients, 95%). Conversely, it is somewhat surprising that most hypertensive patients reached high standards of education and worked at sedentary jobs (group A: 736 patients, 91%; P < 0.0001). Multivariate analysis showed that only diastolic blood pressure (P = 0.03) was independently associated with low educational level. Compared to diabetes, hypertension and its risk factors are relatively unknown to people with little education. Education is associated with greater health care and awareness that may overcome the risk related to low physical activity. Thus, we stress the importance of a sound health policy able to reach out to the uneducated and make them aware of hypertension and the health care services available to them.
这是第一项在大量高血压门诊患者样本中评估教育水平的欧洲研究。我们确定了本单位高血压门诊患者的教育水平，并判断高血压及其器官损害的知晓情况是否与教育程度相关。我们分析了812例连续的原发性I-II期高血压门诊患者（378名男性，平均年龄50±10岁）的数据。受试者被分为两类：A组受试者受教育程度高；B组受试者受教育程度低。将数据与坎帕尼亚地区1991年人口普查的教育水平数据（意大利国家统计局数据）以及最近糖尿病科的200例2型糖尿病患者（96名男性，平均年龄51±9岁）的数据进行比较。对于每一位高血压患者，我们考量了临床、超声心动图和生化参数。上次人口普查的数据显示，受教育程度低的受试者比例很高（80%）。受教育程度低的2型糖尿病患者比例也很高（190例患者，95%）。相反，令人有些惊讶的是，大多数高血压患者达到了较高的教育水平且从事久坐工作（A组：736例患者，91%；P<0.0001）。多变量分析显示，只有舒张压（P = 0.03）与低教育水平独立相关。与糖尿病相比，受教育程度低的人群对高血压及其危险因素了解相对较少。教育与更好的医疗保健及认知相关，这可能会克服与低体力活动相关的风险。因此，我们强调健全的健康政策的重要性，该政策应能惠及未受过教育的人群，使他们了解高血压以及可供他们使用的医疗服务。
