Bharucha Nadir E, Kuruvilla Thomas
Department of Neuroepidemiology, Medical Research Center, Bombay Hospital, Mumbai-400020 India.
BMC Public Health. 2003 Jan 6;3:1. doi: 10.1186/1471-2458-3-1.
Uncontrolled hypertension (HT) is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community.
We used a 1 in 4 random selection of subjects who were > or = 20 years of age. A questionnaire was administered and the blood pressure (BP) was measured by a doctor. HT was defined as diastolic blood pressure (DBP) > or = 90 mm Hg +/- systolic pressure (SBP) > or = 140 mm Hg. Isolated systolic hypertension (ISH) was defined as SBP > or = 160 mm Hg with DBP < 90 mm Hg. Subsequently, we reanalysed the data using current definition of ISH as SBP > or = 140 mm Hg with DBP < 90 mm Hg.
2879 subjects > or = 20 years of age were randomly selected of which 2415 (84%) participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives > or = 60 years had ISH.
This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community.
未控制的高血压是血管疾病发生的既定危险因素。其患病率在不同社区有所不同，而针对居住在印度孟买的帕西社区尚未开展此类研究。本研究的目的是确定该社区高血压的患病率、知晓率、药物依从性及控制情况。
我们从年龄大于或等于20岁的人群中按四分之一的比例随机选取研究对象。进行问卷调查，并由医生测量血压。高血压定义为舒张压（DBP）大于或等于90毫米汞柱且收缩压（SBP）大于或等于140毫米汞柱。单纯收缩期高血压（ISH）定义为收缩压大于或等于160毫米汞柱且舒张压小于90毫米汞柱。随后，我们使用ISH的现行定义（收缩压大于或等于140毫米汞柱且舒张压小于90毫米汞柱）重新分析数据。
随机选取了2879名年龄大于或等于20岁的研究对象，其中2415人（84%）参与了研究。该社区高血压的总体患病率为36.4%，其中48.5%的人未意识到自己患有高血压。在知晓自己患有高血压的人群中，36.4%未遵医嘱服用降压药，只有13.6%的人血压得到了最佳控制。按照目前标准，ISH的患病率为19.5%，60岁及以上的高血压患者中有73%患有ISH。
本研究表明，帕西社区高血压患病率较高，近一半的人未意识到自己患有高血压。ISH是老年人高血压的主要形式。治疗依从性较差，只有少数人实现了血压的最佳控制。该研究强调了在社区进行定期筛查并结合教育项目以检测和最佳治疗高血压的必要性。
