Scheltens T, Bots M L, Numans M E, Grobbee D E, Hoes A W
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
J Hum Hypertens. 2007 Feb;21(2):99-106. doi: 10.1038/sj.jhh.1002123. Epub 2006 Nov 30.
Detection, treatment and control of high blood pressure in many populations are insufficient. We reported current prevalence, awareness, treatment and control of hypertension in the Netherlands and compared the findings with other studies. Furthermore, we related actual treatment of hypertension to estimated absolute 10-year cardiovascular risk, as according to current guidelines on this subject, initiation of blood pressure-lowering treatment depends on the level of cardiovascular risk. The Utrecht Health Project is a prospective cohort study in a suburb of Utrecht. Information on medical history, life style and measurements of blood pressure, cholesterol and glucose of the first 4950 participants of the study was obtained. Cardiovascular risks were calculated using the Framingham risk function. Prevalence of hypertension was 23.3%. Among those with hypertension, 33.7% was aware of the condition. Of those aware, 59.4% was treated. Of those treated, 41.9% had blood pressure below the recommended level. In half of those aware of their hypertension, and a calculated cardiovascular risk less than 10%, treatment of hypertension was started unnecessary. Of those aware of their hypertension with a calculated cardiovascular 10 years risk exceeding the treatment threshold of 20%, treatment was absent in 33.6%. Awareness and control of hypertension are still inadequate in the Netherlands and comparable with other European countries. Management of hypertension is too often not risk-based despite recommendations in guidelines on prevention of cardiovascular diseases available since 2000.
许多人群中高血压的检测、治疗和控制情况不足。我们报告了荷兰目前高血压的患病率、知晓率、治疗率和控制率，并将研究结果与其他研究进行了比较。此外，我们将高血压的实际治疗情况与估计的10年绝对心血管风险相关联，因为根据当前关于该主题的指南，降压治疗的启动取决于心血管风险水平。乌得勒支健康项目是在乌得勒支郊区进行的一项前瞻性队列研究。获取了该研究前4950名参与者的病史、生活方式以及血压、胆固醇和血糖测量信息。使用弗明汉风险函数计算心血管风险。高血压患病率为23.3%。在高血压患者中，33.7%知晓自己的病情。在知晓病情的患者中，59.4%接受了治疗。在接受治疗的患者中，41.9%的血压低于推荐水平。在一半知晓自己患有高血压且计算出的心血管风险低于10%的患者中，不必要地开始了高血压治疗。在知晓自己患有高血压且计算出的10年心血管风险超过20%的治疗阈值的患者中，33.6%未接受治疗。荷兰高血压的知晓率和控制率仍然不足，与其他欧洲国家相当。尽管自2000年以来就有关于预防心血管疾病的指南建议，但高血压管理往往并非基于风险。
