Tu Karen, Chen Zhongliang, Lipscombe Lorraine L
Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ont.
CMAJ. 2008 May 20;178(11):1429-35. doi: 10.1503/cmaj.071283.
Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated.
We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004.
The number of adults with hypertension more than doubled from 1995 to 2005. The age- and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age- and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001).
Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed.
研究人员预测,从2000年到2025年,发达国家高血压患病率将相对增加24%。高血压是导致死亡、中风、心血管疾病和肾脏疾病的主要风险因素。因此,准确估计人群中高血压的患病率对公共政策具有重要意义。我们试图评估高血压患病率的估计增长是否被低估。
我们利用加拿大人口最多的安大略省(居民超过1200万)20岁及以上成年人的关联行政数据进行了一项基于人群的队列研究。使用经过验证的高血压病例定义算法,我们研究了1995年至2005年的患病率趋势以及1997年至2004年的发病率趋势。
从1995年到2005年,患有高血压的成年人数量增加了一倍多。年龄和性别调整后的患病率从1995年每1000名成年人中的153.1例增加到2005年的每1000名中的244.8例,相对增加了60.0%(p<0.001)。年龄和性别调整后的高血压发病率从1997年每1000名成年人中的25.5例增加到2004年的每1000名中的32.1例,相对增加了25.7%(p<0.001)。
我们的研究结果表明,高血压患病率的上升可能远远超过2025年的预测患病率。迫切需要预防和管理高血压及其后遗症的公共卫生策略。