Guo X, Zheng L, Zhang X, Zou L, Li J, Sun Z, Hu J, Sun Y
Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China.
Cardiovasc J Afr. 2012 Feb;23(1):44-50. doi: 10.5830/CVJA-2011-058.
Prehypertension appears to be a precursor of hypertension and has been recognised as a major risk factor for cardiovascular disease (CVD). Recognition of prehypertension provides important opportunities for preventing hypertension and CVD. We aimed to investigate the worldwide prevalence and heterogeneity of prehypertension.
We performed a meta-analysis of cross-sectional studies worldwide that reported the prevalence of prehypertension. We searched for publications between January 1966 and November 2010, using PubMed, Ovid and the Cochrane Library, with the keyword 'prehypertension', supplemented by a manual search of references from recent reviews and relevant published original studies. Pooled prevalence of prehypertension was calculated using random-effects models. Heterogeneity was investigated by subgroup analysis and meta-regression. Twenty-two articles met our inclusion criteria, with a total sample of 242 322 individuals.
The overall pooled prevalence of prehypertension was 38%. Significant heterogeneity across estimates of prevalence was observed (p = 0.000, I(2) = 99.9%). The prevalence rose as the sample size increased, and was higher among men than women (41 vs 34%). The non-Asian population was more likely to be prehypertensive than Asian individuals (42 vs 36%). A high prevalence of 47% was observed among the black African population in the non-Asian subgroup. The inception year of the surveys was the only source of heterogeneity we found by meta-regressional analysis (p = 0.06).
These results indicate that the prevalence of prehypertension was relatively high, particularly among males. Although more attention has been paid to this segment of the population since 2003, additional practical and reasonable steps should be taken to prevent and treat prehypertension.
高血压前期似乎是高血压的先兆，并且已被公认为是心血管疾病（CVD）的主要危险因素。认识到高血压前期为预防高血压和心血管疾病提供了重要契机。我们旨在调查全球高血压前期的患病率及其异质性。
我们对全球范围内报告高血压前期患病率的横断面研究进行了荟萃分析。我们使用PubMed、Ovid和Cochrane图书馆，以“高血压前期”为关键词，搜索了1966年1月至2010年11月期间的出版物，并辅以对近期综述和相关已发表原始研究的参考文献进行手工检索。使用随机效应模型计算高血压前期的合并患病率。通过亚组分析和Meta回归研究异质性。22篇文章符合我们的纳入标准，总样本量为242322人。
高血压前期的总体合并患病率为38%。观察到患病率估计值之间存在显著异质性（p = 0.000，I² = 99.9%）。患病率随样本量增加而上升，男性高于女性（41%对34%）。非亚洲人群比亚洲人群更易患高血压前期（42%对36%）。在非亚洲亚组的非洲黑人人群中观察到47%的高患病率。调查的起始年份是我们通过Meta回归分析发现的唯一异质性来源（p = 0.06）。
这些结果表明，高血压前期的患病率相对较高，尤其是在男性中。尽管自2003年以来对这部分人群给予了更多关注，但仍应采取额外切实可行且合理的措施来预防和治疗高血压前期。
