Carlsson Axel C, Wändell Per E, Journath Gunilla, de Faire Ulf, Hellénius Mai-Lis
Department of Neurobiology, Care Sciences and Society, Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
Hypertens Res. 2009 Sep;32(9):780-5. doi: 10.1038/hr.2009.94. Epub 2009 Jun 26.
The objective of this study was to describe cardiovascular risk profiles of 60-year-olds with uncontrolled diagnosed hypertension (>or=140/90 mm Hg) in comparison with individuals with controlled diagnosed hypertension. To study how medical, lifestyle and socioeconomic factors are associated with uncontrolled diagnosed hypertension in men and women separately, a population-based, cross-sectional study of 4228 60-year-olds in Sweden, of whom 503 men and 445 women had previously diagnosed hypertension, was conducted. Physical examination including measuring blood pressure was carried out, and a medical/lifestyle/socioeconomic questionnaire was completed. Only 22% of the men and 33% of the women with diagnosed hypertension had a blood pressure below 140/90 mm Hg. Both men and women had multiple cardiovascular risk factors in addition to hypertension. Antihypertensive monotherapy was more common in men and women with controlled hypertension. None of the participants without pharmacological treatment had a controlled blood pressure. Four factors were independently associated with uncontrolled hypertension in men: waist circumference above 97 cm (odds ratio (OR)=1.85, confidence interval (CI)=1.17-2.92), coronary heart disease (CHD) (OR=0.28, CI=0.17-0.46), no health care for financial reasons (OR=2.71, CI=1.09-6.78) and daily intake of fruit (OR=0.59, CI=0.37-0.93). In women, three factors remained independently associated: waist circumference above 78 cm (OR=1.93, CI=1.09-3.43), CHD (OR=0.36, CI=0.18-0.72) and living in an apartment (OR=0.55, CI=0.35-0.85). More efforts are warranted to reduce blood pressure and to modulate associated risk factors to be able to reduce the high morbidity and mortality observed in individuals with hypertension.
本研究的目的是描述确诊为高血压（≥140/90毫米汞柱）且血压未得到控制的60岁人群的心血管风险状况，并与血压得到控制的确诊高血压患者进行比较。为了分别研究医疗、生活方式和社会经济因素如何与男性和女性未得到控制的确诊高血压相关联，在瑞典对4228名60岁人群开展了一项基于人群的横断面研究，其中503名男性和445名女性此前已确诊患有高血压。进行了包括测量血压在内的体格检查，并完成了一份医疗/生活方式/社会经济调查问卷。在确诊高血压的男性中，只有22%的人血压低于140/90毫米汞柱，女性中这一比例为33%。除高血压外，男性和女性均有多种心血管危险因素。在血压得到控制的男性和女性中，抗高血压单药治疗更为常见。未接受药物治疗的参与者中，无人血压得到控制。有四个因素与男性未得到控制的高血压独立相关：腰围超过97厘米（比值比（OR）=1.85，置信区间（CI）=1.17 - 2.92）、冠心病（CHD）（OR=0.28，CI=0.17 - 0.46）、因经济原因未接受医疗保健（OR=2.71，CI=1.09 - 6.78）以及水果每日摄入量（OR=0.59，CI=0.37 - 0.93）。在女性中，有三个因素仍然独立相关：腰围超过78厘米（OR=1.93，CI=1.09 - 3.43）、冠心病（OR=0.36，CI=0.18 - 0.72）以及居住在公寓中（OR=0.55，CI=0.35 - 0.85）。有必要做出更多努力来降低血压并调节相关危险因素，以便能够降低高血压患者中观察到的高发病率和死亡率。
