Scuteri A, Najjar S S, Orru' M, Albai G, Strait J, Tarasov K V, Piras M G, Cao A, Schlessinger D, Uda M, Lakatta E G
UO Geriatria, INRCA, IRCCS, Via Cassia 1167, 00189 Rome, Italy.
Nutr Metab Cardiovasc Dis. 2009 Oct;19(8):532-41. doi: 10.1016/j.numecd.2008.11.004. Epub 2009 Mar 25.
We investigated the gender-specific control of cardiovascular (CV) risk factors and subclinical vascular lesions in a founder population in Italy.
6148 subjects were enrolled (aged 14-102 years) from four towns. Hypertension (HT), diabetes mellitus (DM) and dyslipidemia (LIP) were defined in accordance with guidelines. A self-reported diagnosis defined awareness of these conditions, and the current use of specific medications as treatment. Prevalence was HT 29.2%, DM 4.8%, LIP 44.1% and was higher in men than in women. Disease prevalence increased with age for every CV risk factor. Men were less likely than women to take anti-HT drugs and to reach BP control (9.9% vs. 16%). Only 17.6% of HT > 65 years had a BP < or =140/90 mmHg, though 48.5% were treated. The use of statins was very low (<1/3 of eligible subjects > 65 years, those with the highest treatment rate). The ratio of control-to-treated HT was lower in subjects with, than in those without, thicker carotid arteries (31.5% vs. 38.8%, p < 0.05) or stiffer aortas (26.0% vs. 40.0%, p < 0.05) or carotid plaques (26.3% vs. 41.1%, p<0.05).
A large number of subjects at high CV risk are not treated and the management of subclinical vascular lesions is far from optimal.
我们在意大利的一个创始人群体中研究了心血管(CV)危险因素和亚临床血管病变的性别特异性控制情况。
从四个城镇招募了6148名受试者(年龄14 - 102岁)。高血压(HT)、糖尿病(DM)和血脂异常(LIP)根据指南进行定义。自我报告的诊断确定了对这些疾病的知晓情况,以及当前使用特定药物进行治疗的情况。患病率分别为HT 29.2%、DM 4.8%、LIP 44.1%,男性高于女性。每种CV危险因素的疾病患病率均随年龄增加。男性服用抗高血压药物并达到血压控制的可能性低于女性(9.9%对16%)。尽管48.5%的65岁以上高血压患者接受了治疗,但只有17.6%的患者血压<或=140/90 mmHg。他汀类药物的使用率非常低(65岁以上符合条件的受试者中<1/3,这些人治疗率最高)。有颈动脉增厚、主动脉僵硬或颈动脉斑块的受试者中,高血压控制与治疗的比例低于没有这些情况的受试者(31.5%对38.8%,p<0.05;26.0%对40.0%,p<0.05;26.3%对41.1%,p<0.05)。
大量具有高CV风险的受试者未得到治疗,亚临床血管病变的管理远未达到最佳状态。