Gan S K E, Loh C Y, Seet B
Medical Classification Centre, Ministry of Defence, 3 Depot Road #03-17, Singapore 109680.
Singapore Med J. 2003 Sep;44(9):448-52.
To study the prevalence of hypertension and "white coat hypertension" in young adult Asian males, and identify the associated risk factors.
Population-based descriptive analysis of 3,352 Singapore military conscripts presenting consecutively for medical screening, followed by case-control study of subjects with elevated blood pressure. A standard protocol for assessing elevated blood pressure, 24-hour ambulatory monitoring and detailed interviews were performed. Main study outcomes are prevalence rate of hypertension and "white coat hypertension", mean blood pressure readings, and adjusted odds ratios for associated variables.
Prevalence of hypertension and "white coat hypertension" was 1.6% (95% CI 1.2, 2.0) and 2.0% (95% CI 1.5, 2.5) respectively. Twenty-four-hour ambulatory monitoring was required to differentiate the two conditions, with a fall of 22.5 mmHg (95% CI 19.7, 25.3) observed between first visit and day-time ambulatory mean systolic blood pressures. There was strong association between hypertension and obesity (adjusted odds ratio using Body Mass Index: 1.19, p<0.001). Other important variables included parental history of hypertension, Malay ethnicity and low socio-economic status, although there was no significant correlation in our regression model.
This study provides population-based data on hypertension in young Asian adults. While the prevalence of hypertension is low compared to older age groups, it remains important to detect cases early, as appropriate treatment may mitigate long-term cardiovascular risks and reduce target organ damage. There is a clear role for ambulatory blood pressure monitoring for differentiating true hypertension from "white coat hypertension". There may be a role for targeted screening of high-risk groups, particularly the obese.
研究亚洲年轻成年男性高血压和“白大衣高血压”的患病率，并确定相关危险因素。
对3352名连续接受医学筛查的新加坡应征入伍军人进行基于人群的描述性分析，随后对血压升高的受试者进行病例对照研究。采用标准方案评估血压升高情况、进行24小时动态血压监测并开展详细访谈。主要研究结果为高血压和“白大衣高血压”的患病率、平均血压读数以及相关变量的调整比值比。
高血压和“白大衣高血压”的患病率分别为1.6%（95%可信区间1.2，2.0）和2.0%（95%可信区间1.5，2.5）。需要通过24小时动态血压监测来区分这两种情况，首次就诊时与日间动态平均收缩压之间观察到下降22.5 mmHg（95%可信区间19.7，25.3）。高血压与肥胖之间存在强关联（使用体重指数的调整比值比：1.19，p<0.001）。其他重要变量包括高血压家族史、马来族裔和社会经济地位低，尽管在我们的回归模型中无显著相关性。
本研究提供了关于亚洲年轻成年人高血压的基于人群的数据。虽然与老年人群相比高血压患病率较低，但早期发现病例仍然很重要，因为适当治疗可能减轻长期心血管风险并减少靶器官损害。动态血压监测在区分真正的高血压与“白大衣高血压”方面有明确作用。对高危人群，尤其是肥胖者进行针对性筛查可能有作用。
