Medina-Lezama Josefina, Zea-Diaz Humberto, Morey-Vargas Oscar L, Bolaños-Salazar Juan F, Postigo-Macdowall Mauricio, Paredes-Díaz Sheyla, Corrales-Medina Fernando, Valdivia-Ascuña Zoila, Cuba-Bustinza Carolina, Villalobos-Tapia Paola, Muñoz-Atahualpa Edgar, Chirinos-Pacheco Julio, Raij Leopoldo, Chirinos Julio A
Santa Maria Catholic University School of Medicine and Santa Maria Research Institute, Arequipa, Peru.
J Am Soc Hypertens. 2007 May-Jun;1(3):216-25. doi: 10.1016/j.jash.2007.02.003.
Cardiovascular disease is emerging as a leading cause of morbidity and mortality in Latin America. Population-based data regarding the prevalence of hypertension and hypertension subtypes in Andean Hispanic populations are scarce. The authors performed a population-based study that included 1878 Peruvian Andean adults to determine: (1) the prevalence, awareness, and control of hypertension and (2) the relative frequency of hypertension subtypes (systolic vs. diastolic). The prevalence of hypertension was 15.7% (95% confidence interval [CI], 14.0%-17.4%), did not differ by gender, and increased steeply with age, particularly in women. Awareness, treatment, and control rates were 47.9%, 39.5%, and 14%, respectively. Diastolic blood pressure increased until age 50 years and reached a plateau thereafter, whereas mean arterial pressure continued to increase with age even after age 50 years. Furthermore, in sharp contrast with the United States population, the predominant type of hypertension was systodiastolic (41.7%; 95% CI, 35.1%-48.5%). Isolated systolic hypertension accounted for only 29.3% of cases (95% CI, 23.9%-35.4%) and was responsible for a minority of cases in all age groups before age 70 years. Hypertension subtypes in this Andean population seem to differ significantly from those present in the United States population, with a much larger proportion of systodiastolic and diastolic hypertension even with advanced age. These differences result from interactions between hemodynamic and structural factors, and further studies aimed at characterizing their genetic and environmental determinants and implications in end-organ damage and prognosis in this population may contribute to understanding the pathophysiology of hypertension.
心血管疾病正成为拉丁美洲发病和死亡的主要原因。关于安第斯西班牙裔人群中高血压及其亚型患病率的基于人群的数据稀缺。作者开展了一项基于人群的研究，纳入了1878名秘鲁安第斯成年人，以确定：（1）高血压的患病率、知晓率和控制率；（2）高血压亚型（收缩期与舒张期）的相对频率。高血压患病率为15.7%（95%置信区间[CI]，14.0%-17.4%），无性别差异，且随年龄急剧增加，尤其是在女性中。知晓率、治疗率和控制率分别为47.9%、39.5%和14%。舒张压在50岁前升高，此后趋于平稳，而平均动脉压即使在50岁后仍随年龄继续升高。此外，与美国人群形成鲜明对比的是，高血压的主要类型是收缩期舒张期高血压（41.7%；95%CI，35.1%-48.5%）。单纯收缩期高血压仅占病例的29.3%（95%CI，23.9%-35.4%），且在70岁前的所有年龄组中占少数病例。该安第斯人群的高血压亚型似乎与美国人群有显著差异，即使在高龄时，收缩期舒张期高血压和舒张期高血压的比例也大得多。这些差异是由血流动力学和结构因素之间的相互作用导致的，旨在表征其遗传和环境决定因素及其对该人群终末器官损害和预后的影响的进一步研究可能有助于理解高血压的病理生理学。
