Gupta R
Department of Medicine, Monilek Hospital and Research Centre, Jawahar Nagar, Jaipur, India.
J Hum Hypertens. 2004 Feb;18(2):73-8. doi: 10.1038/sj.jhh.1001633.
Cardiovascular diseases caused 2.3 million deaths in India in the year 1990; this is projected to double by the year 2020. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Indian urban population studies in the mid-1950s used older WHO guidelines for diagnosis (BP > or =160 and/or 95 mmHg) and reported hypertension prevalence of 1.2-4.0%. Subsequent studies report steadily increasing prevalence from 5% in 1960s to 12-15% in 1990s. Hypertension prevalence is lower in the rural Indian population, although there has been a steady increase over time here as well. Recent studies using revised criteria (BP > or =140 and/or 90 mmHg) have shown a high prevalence of hypertension among urban adults: men 30%, women 33% in Jaipur (1995), men 44%, women 45% in Mumbai (1999), men 31%, women 36% in Thiruvananthapuram (2000), 14% in Chennai (2001), and men 36%, women 37% in Jaipur (2002). Among the rural populations, hypertension prevalence is men 24%, women 17% in Rajasthan (1994). Hypertension diagnosed by multiple examinations has been reported in 27% male and 28% female executives in Mumbai (2000) and 4.5% rural subjects in Haryana (1999). There is a strong correlation between changing lifestyle factors and increase in hypertension in India. The nature of genetic contribution and gene-environment interaction in accelerating the hypertension epidemic in India needs more studies. Pooling of epidemiological studies shows that hypertension is present in 25% urban and 10% rural subjects in India. At an underestimate, there are 31.5 million hypertensives in rural and 34 million in urban populations. A total of 70% of these would be Stage I hypertension (systolic BP 140-159 and/or diastolic BP 90-99 mmHg). Recent reports show that borderline hypertension (systolic BP 130-139 and/or diastolic BP 85-89 mmHg) and Stage I hypertension carry a significant cardiovascular risk and there is a need to reduce this blood pressure. Population-based cost-effective hypertension control strategies should be developed.
1990年，心血管疾病在印度导致230万人死亡；预计到2020年这一数字将翻倍。在印度，高血压直接导致了57%的中风死亡病例和24%的冠心病死亡病例。20世纪50年代中期对印度城市人口的研究采用了世界卫生组织较旧的诊断指南（血压≥160和/或95毫米汞柱），报告的高血压患病率为1.2% - 4.0%。随后的研究报告显示患病率稳步上升，从20世纪60年代的5%升至20世纪90年代的12% - 15%。印度农村人口的高血压患病率较低，不过随着时间推移也在稳步上升。最近采用修订标准（血压≥140和/或90毫米汞柱）的研究表明，城市成年人中高血压患病率很高：斋浦尔男性为30%，女性为33%（1995年）；孟买男性为44%，女性为45%（1999年）；特里凡得琅男性为31%，女性为36%（2000年）；钦奈为14%（2001年）；斋浦尔男性为36%，女性为37%（2002年）。在农村人口中，拉贾斯坦邦高血压患病率男性为24%，女性为17%（1994年）。孟买报告称，通过多次检查诊断出高血压的男性高管为27%，女性高管为28%（2000年）；哈里亚纳邦农村受试者为4.5%（1999年）。在印度，生活方式因素的变化与高血压患病率的增加之间存在很强的相关性。关于基因在印度高血压流行加速过程中的贡献性质以及基因 - 环境相互作用，还需要更多研究。汇总的流行病学研究表明，印度城市人口中有25%、农村人口中有10%患有高血压。保守估计，农村有3150万高血压患者，城市有3400万。其中70%为I期高血压（收缩压140 - 159和/或舒张压90 - 99毫米汞柱）。最近的报告显示，临界高血压（收缩压130 - 139和/或舒张压85 - 89毫米汞柱）和I期高血压具有显著的心血管风险，需要降低这种血压水平。应制定基于人群的具有成本效益的高血压控制策略。
