Department of Community Health, Brown University, Rhode Island, New York, USA.
J Hypertens. 2010 Jan;28(1):15-23. doi: 10.1097/HJH.0b013e328331b7ff.
Little is known about isolated systolic hypertension (ISH) in younger adults. We examined the prevalence and determinants of ISH in this age group using the 1999-2004 National Health and Nutrition Examination Surveys (NHANES) and made comparisons using data from NHANES III (1988-1994).
A total of 5685 adults aged 18-39 years and not on antihypertensive medications were analyzed. Prevalence estimates of ISH and potential risk factors were estimated by age and sex. For comparison of prevalence estimates with published reports of NHANES III data, age cutoffs (18-24, 25-34, and 35-44 year) by sex were also employed. A multivariate logistic regression model tested independent determinants of ISH.
ISH in young adults had a higher prevalence than systolic/diastolic hypertension (1.57 +/- 0.23% vs. 0.93 +/- 0.18%). ISH prevalence increased within the last decade particularly for men for each respective age category [men (0.8 vs. 2.2%, 1.3 vs. 2.4%, 1.3 vs. 2.4%), women (0.0 vs. 0.3%, 0.1 vs. 0.7%, 1.7 vs. 1.8%)]. On multivariate analysis, obesity [odds ratio (OR): 2.68, 95% confidence interval (CI): 1.06, 6.77], male sex (OR: 2.19, 95% CI: 1.10, 4.37), education level less than high school (OR: 2.98, 95% CI: 1.10, 8.06), and current smoking (OR: 2.06, 95% CI: 1.03, 4.11) were characteristics independently associated with higher odds of ISH among young adults. Relative increases in prevalence between the surveys were noted for current smoking (24.3 vs. 51.5%), obesity (33.9 vs. 42.7%) and low educational level (18.4 vs. 38.6%).
ISH among young adults is increasing in prevalence, and is more common than systolic/diastolic hypertension. Obesity, smoking, and low socioeconomic status appear to be important determinants of ISH among young adults and have all increased over the last decade.
关于年轻成年人的单纯收缩期高血压（ISH）知之甚少。我们使用 1999-2004 年全国健康和营养检查调查（NHANES）检查了该年龄组中 ISH 的患病率和决定因素，并使用 NHANES III（1988-1994 年）的数据进行了比较。
共分析了 5685 名年龄在 18-39 岁且未服用抗高血压药物的成年人。按年龄和性别估计 ISH 的患病率估计值和潜在危险因素。为了比较与 NHANES III 数据公布报告的患病率估计值，还按性别使用了年龄截断值（18-24、25-34 和 35-44 岁）。多变量逻辑回归模型测试了 ISH 的独立决定因素。
年轻成年人的 ISH 患病率高于收缩压/舒张压高血压（1.57 +/- 0.23% vs. 0.93 +/- 0.18%）。ISH 的患病率在过去十年中有所上升，特别是对于每个年龄段的男性[男性（0.8%对 2.2%、1.3%对 2.4%、1.3%对 2.4%），女性（0.0%对 0.3%、0.1%对 0.7%、1.7%对 1.8%）]。在多变量分析中，肥胖[比值比（OR）：2.68，95%置信区间（CI）：1.06，6.77]、男性（OR：2.19，95%CI：1.10，4.37）、受教育程度低于高中（OR：2.98，95%CI：1.10，8.06）和当前吸烟（OR：2.06，95%CI：1.03，4.11）是与年轻成年人 ISH 较高几率相关的独立特征。在两个调查之间，注意到当前吸烟（24.3%对 51.5%）、肥胖（33.9%对 42.7%）和低教育水平（18.4%对 38.6%）的患病率相对增加。
年轻成年人的 ISH 患病率正在上升，且比收缩压/舒张压高血压更为常见。肥胖、吸烟和低社会经济地位似乎是年轻成年人 ISH 的重要决定因素，而且这三个因素在过去十年中都有所增加。
