Banegas J R, de la Cruz J J, Rodríguez-Artalejo F, Graciani A, Guallar-Castillón P, Herruzo R
Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid. Madrid, Spain.
J Hum Hypertens. 2002 Mar;16(3):163-7. doi: 10.1038/sj.jhh.1001310.
Systolic blood pressure (SBP) is a more frequent cardiovascular risk factor than diastolic blood pressure (DBP), and has a greater impact on blood pressure staging, though this can vary with age, sex and country. Therefore this paper compares SBP and DBP in terms of community burden and impact on blood pressure staging, among Spain's middle-aged population. Data were drawn from a cross-sectional study on a representative sample of the Spanish population aged 35-64 years. Blood pressure was determined under standardised conditions, and was classified as per WHO-ISH and JNC-VI criteria. Prevalence of SBP > or =140 mm Hg was 34.1%, and that of DBP > or =90 mm Hg, 30.9%. A total of 12% of subjects had isolated systolic hypertension (ISH) and 8.7% had isolated diastolic hypertension (IDH). Of treated hypertensives, 31% had their SBP controlled and 34% their DBP controlled. Of subjects not undergoing antihypertensive drug therapy, 60.8% had congruent SBP and DBP levels, 22.5% were up-staged on the basis of their SBP, and 16.7% were up-staged on the basis of their DBP. SBP alone thus correctly classified JNC-VI staging in 83.3% of subjects vs 77.5% for DBP alone. It was solely among the population >50 years of age, in both sexes, that systolic proved more frequent than diastolic hypertension, ISH greater than IDH prevalence, SBP worse than DBP control, and the percentage of SBP higher than that of DBP up-staged subjects. SBP constitutes a greater community burden than does DBP, and has a greater impact on blood pressure staging in Spain's middle-aged population. However, the differential impact of SBP and DBP upon blood pressure burden and staging is favourable to SBP only among subjects >50 years old. These findings are in accordance with recent guidelines on hypertension management.
收缩压（SBP）作为心血管危险因素比舒张压（DBP）更为常见，对血压分级的影响也更大，不过这种情况会因年龄、性别和国家而有所不同。因此，本文比较了西班牙中年人群中SBP和DBP在社区负担及对血压分级影响方面的差异。数据来自一项对35 - 64岁西班牙人群代表性样本的横断面研究。血压在标准化条件下测定，并根据WHO - ISH和JNC - VI标准进行分类。SBP≥140 mmHg的患病率为34.1%，DBP≥90 mmHg的患病率为30.9%。共有12%的受试者患有单纯收缩期高血压（ISH），8.7%患有单纯舒张期高血压（IDH）。在接受治疗的高血压患者中，31%的SBP得到控制，34%的DBP得到控制。在未接受抗高血压药物治疗的受试者中，60.8%的SBP和DBP水平一致，22.5%根据SBP被上调分级，16.7%根据DBP被上调分级。仅SBP就能正确分类JNC - VI分级的受试者比例为83.3%，而仅DBP为77.5%。仅在50岁以上的男女群体中，收缩期高血压比舒张期高血压更常见，ISH患病率高于IDH，SBP控制情况比DBP差，且SBP高于DBP上调分级受试者的比例。SBP在西班牙中年人群中构成的社区负担比DBP更大，对血压分级的影响也更大。然而，SBP和DBP对血压负担和分级的差异影响仅在50岁以上的受试者中对SBP有利。这些发现与最近的高血压管理指南一致。
