Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Eval Clin Pract. 2011 Feb;17(1):130-5. doi: 10.1111/j.1365-2753.2010.01379.x. Epub 2010 Sep 12.
Woman have lower rate of hypertension than man but it is still elusive how such gender difference can be explained by kinetic epidemiological curves.
The aim of this paper was to develop a multi-state model for delineating the kinetic epidemiology of hypertension according to the Seventh Report of the Joint National Committee (JNC 7) classification criteria by gender, and to derive gender-specific kinetic curves.
We used data from a population-based screening programme with 42,027 participants to fit a four-state Markov model corresponding to the classification of hypertension from the JNC 7.
The young man had higher progression rate but lower regression rate for the movement between normal and pre-hypertension than the young woman. Such gender difference disappeared after 50 years old. The mean sojourn time of pre- and stage 1 hypertension for man and stage 1 for woman was approximately 5 years. However, the corresponding figure for pre-hypertension for woman was 25 years at age 30, 10 years at age 40 and 5 years afterwards.
Elucidating the kinetic epidemiological curves of hypertension explains higher prevalence rate in young man than woman. These findings fit with the role of sex hormones regulating blood pressure demonstrated in the animal model.
女性的高血压发病率低于男性，但动力学流行病学曲线如何解释这种性别差异仍不清楚。
本研究旨在根据第七版联合国家委员会（JNC 7）分类标准，通过性别建立一个多状态模型来描述高血压的动力学流行病学，并得出性别特异性的动力学曲线。
我们使用了一项基于人群的筛查计划中的数据，该计划共有 42027 名参与者，以拟合与 JNC 7 分类相对应的四状态马尔可夫模型。
年轻男性在从正常到高血压前期的运动中，其进展率较高，但回归率较低。这种性别差异在 50 岁后消失。男性的前期和 1 期高血压以及女性的 1 期高血压的平均停留时间约为 5 年。然而，对于女性来说，在 30 岁时，高血压前期的相应停留时间为 25 年，40 岁时为 10 年，之后为 5 年。
阐明高血压的动力学流行病学曲线可以解释为什么年轻人中男性的患病率高于女性。这些发现与动物模型中显示的性激素调节血压的作用相符。
