Danon-Hersch Nadia, Chiolero Arnaud, Shamlaye Conrad, Paccaud Fred, Bovet Pascal
Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Epidemiology. 2007 Jul;18(4):493-500. doi: 10.1097/EDE.0b013e318063eebf.
Our purpose was to assess blood pressure (BP) and its relationship with body mass index (BMI) over a 15-year interval in the Seychelles, a rapidly developing country in the African region.
Two independent cross-sectional examination surveys were conducted in 1989 (n=1081) and 2004 (n=1255) using representative samples of the population age 25-64 years.
Between 1989 and 2004, mean BP (mm Hg) decreased slightly (from 133/87 to 131/86 in men and from 127/82 to 124/81 in women), with little change in the age-standardized prevalence of high BP (BP >or=140/90 or current treatment; from 45% to 44% in men and from 34% to 36% in women). During this same time period, there were marked increases in awareness (from 42% to 64%), treatment (22% to 59%), and control (3% to 20%) among participants with high BP. The prevalence of overweight (BMI >or=25 kg/m) increased from 39% to 60%. Furthermore, the linear relationship between BMI and BP was markedly weaker in 2004 than in 1989, irrespective of antihypertensive treatment and age, and among both lean and overweight participants. Among untreated persons, a BMI increment of 1 kg/m was associated with an elevation of 2.0/1.5 mm Hg of systolic/diastolic BP in 1989 but only 1.3/1.0 mm Hg in 2004.
The association between BMI and BP has decreased over time. Further study is needed to understand the reasons for the decline in this association, and what the implications are in the context of the obesity epidemic.
我们的目的是评估非洲地区一个快速发展的国家——塞舌尔在15年期间的血压（BP）及其与体重指数（BMI）的关系。
1989年（n = 1081）和2004年（n = 1255）对年龄在25 - 64岁的具有代表性的人群样本进行了两项独立的横断面检查调查。
1989年至2004年期间，平均血压（毫米汞柱）略有下降（男性从133/87降至131/86，女性从127/82降至124/81），高血压（血压≥140/90或正在接受治疗）的年龄标准化患病率变化不大（男性从45%降至44%，女性从34%升至36%）。在同一时期，高血压参与者的知晓率（从42%升至64%）、治疗率（从22%升至59%）和控制率（从3%升至20%）都有显著提高。超重（BMI≥25 kg/m²）的患病率从39%升至60%。此外，无论是否接受降压治疗、年龄如何，以及在瘦人和超重参与者中，2004年BMI与BP之间的线性关系都比1989年明显减弱。在未接受治疗的人群中，1989年BMI每增加1 kg/m²，收缩压/舒张压分别升高2.0/1.5毫米汞柱，而2004年仅升高1.3/1.0毫米汞柱。
随着时间的推移，BMI与BP之间的关联有所减弱。需要进一步研究以了解这种关联下降的原因，以及在肥胖流行背景下其影响如何。
