Juntunen M, Niskanen L, Saarelainen J, Tuppurainen M, Saarikoski S, Honkanen R
Research Institute of Public Health, University of Kuopio, Finland.
J Hum Hypertens. 2003 Nov;17(11):775-9. doi: 10.1038/sj.jhh.1001611.
We assessed the determinants of onset of hypertension in a large, prospective population-based study of perimenopausal women from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study. The data collection started in 1989, when a baseline postal inquiry was sent to all women aged 47-56 years (n=14 220) residing in the Kuopio Province in Eastern Finland. Names, social security numbers and addresses were obtained from the Population Register Centre of Finland. A total of 11 798 women responded at baseline and at 5-year follow-up in 1994. After the exclusion of 1777 women with prevalent hypertension at baseline and women with missing height or weight information, the study population consisted of 9485 without established hypertension at baseline. New cases of established hypertension during the follow-up (n=908) were ascertained with the Registry of Specially Refunded Drugs of the Finnish Social Insurance Institution (SII). According to the National Health Insurance, the SII granted 90% reimbursement for drug costs in defined chronic illnesses necessitating continuous medication, like arterial hypertension. Weight and weight gain both raised the risk by 5% per kg (P<0.001). Weight gain of 4-6 kg increased the risk of hypertension 1.25 times and a gain of more than 7 kg 1.65 times compared with the control (zero) group. To conclude, the onset of hypertension in peri- and early postmenopausal women was related to an increase in body weight despite controlling for initial body weight, reported physical activity and use of HRT. Therefore, preventing weight gain by dietary means and exercise is of great importance at menopausal age.
我们在一项基于人群的大型前瞻性研究中，对来自库奥皮奥骨质疏松症危险因素与预防（OSTPRE）研究的围绝经期妇女高血压发病的决定因素进行了评估。数据收集始于1989年，当时向居住在芬兰东部库奥皮奥省的所有47 - 56岁女性（n = 14220）发送了基线邮政调查问卷。姓名、社会保障号码和地址从芬兰人口登记中心获取。共有11798名女性在1994年的基线和5年随访时做出了回应。在排除1777名基线时患有高血压的女性以及身高或体重信息缺失的女性后，研究人群由9485名基线时未患高血压的女性组成。随访期间确诊的高血压新病例（n = 908）通过芬兰社会保险机构（SII）的特殊报销药物登记处确定。根据国家健康保险，SII为明确的慢性病（如动脉高血压）所需的持续药物治疗的药物费用提供90%的报销。体重和体重增加均使风险每增加1千克就提高5%（P < 0.001）。与对照组（增重为零）相比，体重增加4 - 6千克使高血压风险增加1.25倍，体重增加超过7千克使风险增加1.65倍。总之，尽管对初始体重、报告的身体活动和激素替代疗法的使用进行了控制，但绝经前后和绝经后早期女性高血压的发病与体重增加有关。因此，在绝经年龄通过饮食和运动预防体重增加非常重要。
