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[普通人群高血压的十年发病率:临床参数的影响及对筛查策略的意义]

[Ten-year incidence of high blood pressure in the general population: influence of clinical parameters, and implication for screening strategies].

作者信息

Tourdjman M, Jacobi D, Petit P, Vol S, Tichet J, Halimi J-M

机构信息

Service de néphrologie et immunologie Clinique, CHRU de Tours.

出版信息

Arch Mal Coeur Vaiss. 2007 Aug;100(8):615-9.

Abstract

BACKGROUND

International guidelines recommend to modulate the periodicity of hypertension screening according to the initial level of blood pressure (BP). The aim of our study was to evaluate other factors that could be useful to optimise the screening for hypertension.

METHODS

9777 normotensive volunteers (4151 men, 5626 women) aged 16 to 68, studied at a 10 year interval during systematic health check ups (standardised questionnaire, clinical examination, biological tests) were included. We determined the 10-year incidence of high BP (systolic BP >or=140 mmHg and/or diastolic BP >or=90 mmHg and/or anti-hypertensive treatment). The role of potential risk factors for hypertension was assessed.

RESULTS

The 10 year incidence of high BP was 19.9%. It was associated with the initial level of BP (OR=2.02 and 1.81 per +10 mmHg of systolic and diastolic BP, respectively, p<0.0001). Initial age and BMI were strongly associated with the incidence of a high BP (OR=1.88 / + 10 years and 1.18 / + 1 kg/m2, p<0.0001) after adjustment for the initial systolic BP. In men, a low reported physical activity level, alcohol consumption, and current smoking were independent risk factors (Table1). [table: see text]

CONCLUSION

These results suggest that the recommendations for the screening of hypertension should not be based solely on the initial level of BP.

摘要

背景

国际指南建议根据初始血压水平调整高血压筛查的周期。我们研究的目的是评估其他有助于优化高血压筛查的因素。

方法

纳入了9777名血压正常的志愿者(4151名男性,5626名女性),年龄在16至68岁之间,在系统健康检查(标准化问卷、临床检查、生物学检测)期间每隔10年进行一次研究。我们确定了高血压(收缩压≥140 mmHg和/或舒张压≥90 mmHg和/或接受抗高血压治疗)的10年发病率。评估了高血压潜在危险因素的作用。

结果

高血压的10年发病率为19.9%。它与初始血压水平相关(收缩压和舒张压每升高10 mmHg的OR分别为2.02和1.81,p<0.0001)。在对初始收缩压进行调整后,初始年龄和体重指数与高血压发病率密切相关(OR分别为1.88 / +10岁和1.18 / +1 kg/m²,p<0.0001)。在男性中,报告的低体力活动水平、饮酒和当前吸烟是独立危险因素(表1)。[表:见正文]

结论

这些结果表明,高血压筛查的建议不应仅基于初始血压水平。

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