Kastarinen M, Tuomilehto J, Vartiainen E, Jousilahti P, Nissinen A, Puska P
Department of Public Health and General Practice, University of Kuopio, Finland.
J Hum Hypertens. 2002 May;16(5):299-303. doi: 10.1038/sj.jhh.1001322.
Despite the evidence that smoking is one of the main predictors of the cardiovascular disease risk among hypertensive subjects, there are very few data available of the smoking trends of these subjects at public health level. This study assesses the trends in smoking and in smoking cessation advice given by physicians in the hypertensive and normotensive population in Finland during 1982-1997. The data were derived from four independent cross-sectional standardised population surveys conducted in 1982, 1987, 1992 and 1997 in the provinces of North Karelia and Kuopio in eastern Finland and the region of Turku-Loimaa in south-western Finland. Men and women aged 25-64 years, selected randomly from the national population register, were classified to four groups according to their blood pressure level and antihypertensive treatment status: normotensive, unaware hypertensive, aware but not treated hypertensive and treated hypertensive. The total number of participants was 24 083. In men, the prevalence of smoking decreased significantly in both treated hypertensive patients and normotensive subjects during 1982-1997, whereas it increased significantly in treated hypertensive women. The proportion of current smokers who had been advised to stop smoking by their physician was significantly higher in treated hypertensive men compared to the other subgroups of men (P < 0.001). The observed decreasing trend in smoking in men is encouraging, but the increase in smoking among hypertensive women taking antihypertensive medication warrants concern. In the future, the methods used for smoking cessation advice given by health care personnel should be intensified to make this effort more effective.
尽管有证据表明吸烟是高血压患者心血管疾病风险的主要预测因素之一，但在公共卫生层面，关于这些患者吸烟趋势的数据却非常少。本研究评估了1982年至1997年期间芬兰高血压和血压正常人群的吸烟趋势以及医生提供的戒烟建议趋势。数据来源于1982年、1987年、1992年和1997年在芬兰东部的北卡累利阿省和库奥皮奥省以及芬兰西南部的图尔库-洛马地区进行的四项独立的横断面标准化人群调查。从国家人口登记册中随机选取的25至64岁的男性和女性，根据其血压水平和抗高血压治疗状况分为四组：血压正常者、未意识到高血压者、意识到但未接受治疗的高血压患者以及接受治疗的高血压患者。参与者总数为24083人。在男性中，1982年至1997年期间，接受治疗的高血压患者和血压正常者的吸烟率均显著下降，而接受治疗的高血压女性吸烟率则显著上升。与其他男性亚组相比，接受治疗的高血压男性中被医生建议戒烟的当前吸烟者比例显著更高（P < 0.001）。男性吸烟率呈下降趋势令人鼓舞，但服用抗高血压药物的高血压女性吸烟率上升值得关注。未来，应加强医护人员提供戒烟建议的方法，以使这项工作更有效。
