美国高血压成人患者在高血压治疗、药物使用模式及血压控制方面的性别差异:来自1999 - 2004年国家健康与营养检查调查的数据

Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999-2004.

作者信息

Gu Qiuping, Burt Vicki L, Paulose-Ram Ryne, Dillon Charles F

机构信息

Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.

出版信息

Am J Hypertens. 2008 Jul;21(7):789-98. doi: 10.1038/ajh.2008.185. Epub 2008 May 1.

Abstract

BACKGROUND

National guidelines recommend the same approach for treating hypertensive men and women. It is not known, however, whether current US antihypertensive medication utilization patterns and the resulting degrees of blood pressure (BP) control are similar or different among hypertensive women and men.

METHODS

The study was a cross-sectional, nationally representative survey of the noninstitutionalized civilian US population. Persons aged > or =18 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were classified as hypertensive based on a BP > or =140/90 mm Hg, currently taking antihypertensive medication, or having been diagnosed by a physician.

RESULTS

Among hypertensives, the prevalence of antihypertensive medication use was significantly higher among women than men (61.4% vs. 56.8%), especially among middle-aged persons (40-49 years, 53.1% vs. 42.7%) and among non-Hispanic blacks (65.5% vs. 54.6%). Also, treated women were more likely than men to use diuretics (31.6% vs. 22.3%) and angiotensin receptor blockers (11.3% vs. 8.7%). Among treated hypertensives, the proportion taking three or more antihypertensive drugs was lower among women than men, especially among older persons (60-69 years: 12.3% vs. 19.8%, 70-79 years: 18.6% vs. 21.2%, and > or =80 years: 18.8% vs. 22.8%). Only 44.8% of treated women achieved BP control vs. 51.1% of treated men.

CONCLUSIONS

Hypertensive women are significantly more likely to be treated than men, but less likely to have achieved BP control. Additional efforts may be needed to achieve therapeutic goals for the US hypertensive population, especially for hypertensive women.

摘要

背景

国家指南推荐采用相同的方法治疗高血压男性和女性。然而,目前美国抗高血压药物的使用模式以及由此产生的血压控制程度在高血压女性和男性中是相似还是不同尚不清楚。

方法

该研究是一项对美国非机构化平民人口具有全国代表性的横断面调查。1999 - 2004年国家健康和营养检查调查(NHANES)中年龄≥18岁的人,根据血压≥140/90 mmHg、目前正在服用抗高血压药物或已被医生诊断为高血压进行分类。

结果

在高血压患者中,女性使用抗高血压药物的患病率显著高于男性(61.4%对56.8%),尤其是在中年人(40 - 49岁,53.1%对42.7%)和非西班牙裔黑人中(65.5%对54.6%)。此外,接受治疗的女性比男性更有可能使用利尿剂(31.6%对22.3%)和血管紧张素受体阻滞剂(11.3%对8.7%)。在接受治疗的高血压患者中,服用三种或更多抗高血压药物的女性比例低于男性,尤其是在老年人中(60 - 69岁:12.3%对19.8%,70 - 79岁:18.6%对21.2%,≥80岁:18.8%对22.8%)。只有44.8%接受治疗的女性实现了血压控制,而接受治疗的男性为51.1%。

结论

高血压女性接受治疗的可能性明显高于男性,但实现血压控制的可能性较小。可能需要做出更多努力来实现美国高血压人群的治疗目标,尤其是高血压女性。

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