Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
J Hypertens. 2010 Jun;28(6):1158-65. doi: 10.1097/HJH.0b013e3283378568.
To assess the risk of progression to hypertension across baseline blood pressure (BP) level among rural Chinese adults.
A population-based sample of 24 052 rural Chinese adults aged at least 35 years and free from hypertension at baseline were followed up from 2004-2006 to 2008. Incident hypertension was defined as SBP of at least 140 mmHg, DBP of at least 90 mmHg, current use of antihypertensive medication, or all.
During a median follow-up of 28 months, 26.5% participants developed clinical hypertension, most of which were untreated and uncontrolled. The cumulative incidence of hypertension in participants with optimal, normal, and high-normal BP was 21.2, 25.2, and 32.4%, respectively. The higher incidence of hypertension (per 100 person-years) was obviously observed in higher BP category at baseline among both older and younger groups (both P for trend <0.05). Compared with optimal BP, the adjusted hazard ratios of participants with normal and high-normal BP for incident hypertension were 1.16 (95% confidence interval 1.08-1.24) and 1.28 (95% confidence interval 1.20-1.36), respectively. In addition, older age, men, Mongolian ethnicity, alcohol drinking, family history of hypertension, BMI, and change in BMI during follow-up were also independently associated with incident hypertension.
There was a stepwise increase in risk of progression to hypertension across baseline BP level. This information could help us define a population at high risk of progression to hypertension, to underscore the importance of frequent BP monitoring, and early interventions in rural Chinese adults.
评估中国农村成年人基线血压（BP）水平与高血压进展风险的关系。
本研究采用基于人群的样本，纳入了 24052 名年龄至少 35 岁且基线时无高血压的中国农村成年人，随访时间从 2004 年至 2006 年至 2008 年。高血压事件定义为收缩压（SBP）≥140mmHg，舒张压（DBP）≥90mmHg，目前正在使用抗高血压药物，或上述所有情况。
在中位随访 28 个月期间，26.5%的参与者发生了临床高血压，其中大多数未治疗且未得到控制。SBP 处于最佳、正常和高正常范围内的参与者的高血压累积发病率分别为 21.2%、25.2%和 32.4%。在年龄较大和年龄较小的组中，基线时 BP 较高的参与者高血压发病率（每 100 人年）明显更高（趋势 P 值均<0.05）。与最佳 BP 相比，正常和高正常 BP 参与者的高血压发病风险比分别为 1.16（95%置信区间 1.08-1.24）和 1.28（95%置信区间 1.20-1.36）。此外，年龄较大、男性、蒙古族、饮酒、高血压家族史、体重指数（BMI）和随访期间 BMI 的变化也与高血压发病独立相关。
高血压的进展风险随着基线 BP 水平的升高而逐渐增加。这些信息有助于我们确定处于高血压进展高风险的人群，强调了在农村中国成年人中频繁监测血压和早期干预的重要性。
