Russo Domenico, Napolitano Paola, Sirico Maria Luisa, Andreucci Vittorio E
Department of Nephrology, School of Medicine, University of Naples Federico II, Naples - Italy.
J Nephrol. 2007 Jan-Feb;20(1):36-42.
Early identification of subjects unaware of hypertension, diabetes and urinary abnormalities may prevent and/or reduce the onset and progression of kidney disease and ameliorate outcomes. In this study, the presence of hypertension, diabetes and urinary abnormalities was checked in subjects walking in a large square of Naples.
Data on age, habits and history of hypertension and/or diabetes were collected. Systolic and diastolic blood pressure were recorded. Protein, glucose, leukocytes and red blood cells were measured in urine.
Participants numbered 698. Smoking (past or current smoking) was reported by 77%. Many of the participants with hypertension (35%) showed uncontrolled hypertension despite antihypertensive therapy. Hypertension was found for the first time in 154 subjects, and was confirmed in 28% of them afterwards; 23 participants (15% of hypertensive subjects) did not recheck blood pressure (BP) despite our summons. Proteinuria was found in 18% of new hypertensive participants. In 14 out of 17 diabetic participants without history of hypertension, hypertension was found for the first time and confirmed thereafter. Urinary abnormalities were present in more than one half of the participants, and were more prevalent in women and diabetics. Diabetics numbered 55 out of 698 subjects. In spite of therapy, glucosuria was present in almost one third of diabetics. Glucosuria was found in 6 participants with no history of diabetes (0.9% of all subjects).
These data demonstrate that (a) many persons with hypertension are not aware of it; (b) control of hypertension is inadequate in most treated hypertensive patients and even worse in diabetics; (c) urinary abnormalities are frequently present in otherwise healthy subjects; (d) projects with the aim of raising awareness of hypertension, urinary abnormalities and diabetes in out-clinic subjects should be supported; (e) the use of a transportable clinic parked in residential areas of cities appears a suitable way for promoting evaluation of BP and urine test in subjects unaware of disease.
早期识别未意识到自己患有高血压、糖尿病和泌尿系统异常的人群，可能预防和/或减少肾脏疾病的发生及进展，并改善预后。在本研究中，对在那不勒斯一个大广场上行走的人群进行了高血压、糖尿病和泌尿系统异常情况的检查。
收集了关于年龄、生活习惯以及高血压和/或糖尿病病史的数据。记录收缩压和舒张压。检测尿液中的蛋白质、葡萄糖、白细胞和红细胞。
参与者共698人。77%的人报告有吸烟史（过去或现在吸烟）。许多高血压患者（35%）尽管接受了抗高血压治疗，但血压仍未得到控制。154名受试者首次发现患有高血压，之后其中28%得到确诊；23名参与者（占高血压患者的15%）尽管我们多次传唤，仍未复查血压（BP）。18%的新发现高血压参与者存在蛋白尿。在17名无高血压病史的糖尿病参与者中，有14人首次发现高血压并随后得到确诊。超过一半的参与者存在泌尿系统异常，在女性和糖尿病患者中更为普遍。698名受试者中有55名糖尿病患者。尽管接受了治疗，但近三分之一的糖尿病患者仍存在糖尿。在6名无糖尿病病史的参与者中发现了糖尿（占所有受试者的0.9%）。
这些数据表明：（a）许多高血压患者并未意识到自己患病；（b）大多数接受治疗的高血压患者血压控制不佳，糖尿病患者情况更糟；（c）在其他方面健康的受试者中经常存在泌尿系统异常；（d）应支持旨在提高门诊受试者对高血压、泌尿系统异常和糖尿病认识的项目；（e）在城市居民区停放可移动诊所，似乎是促进对未意识到患病的受试者进行血压评估和尿检的合适方式。
