Tangjatuporn Warakarn, Nimitpornsuko Pak, Chindamporn Pornprapa, Srisuwarn Praopilad, Ulit Kittiphit, Sanpantarat Khongrat, Tonglua Chiratha, Jongstapongpun Preecha, Koopitukkajorn Thanthida, Pornrattanakavee Pitchayapa, Chokteerasawad Poo, Homhol Wiriya, Kengpanich Supatcha, Baisopon Sopon, Salyakhamthorn Natta, Ruangkanchanasetr Prajej, Uerojanaungkul Preecha, Chantrarat Thoranis, Areekul Wirote, Panichkul Suthee, Rangsin Ram, Suthijumroon Ampha, Hatthachote Panadda
Phramongkutklao College of Medicine, Bangkok, Thailand.
J Med Assoc Thai. 2012 May;95 Suppl 5:S48-57.
To assess associated factors of uncontrolled blood pressure and complications of hypertension in hypertensive rural Thai populations.
A cross-sectional study was conducted in hypertensive rural Thai people aged > or =35 years-old in Baan Nayao, Chachoengsao Province, Thailand. Blood pressure (BP) was measured and questionnaires were answered. After 12-hr fasting, blood samples were taken for determining plasma glucose, lipid profiles and serum creatinine. Morning urine samples were collected for microalbuminuria testing and electrocardiography (ECG) was performed to detect left ventricular hypertrophy (LVH).
Of the 289 participants (97 males and 192 females) mean duration of hypertension was 4.29 +/- 4.95 years and 61.5% did not achieve target BP control. Among participants who had ECG performed and urine sample investigation, 15.7% demonstrated LVH and 25.3% had microalbuminuria. In uncontrolled BP participants, 20% had LVH and 24.8% had microalbuminuria whereas in controlled BP participants, 7.8% had LVH and 26.1% had microalbuminuria. Uncontrolled BP was associated with males, dyslipidemia, diabetes, abdominal obesity, metabolic syndrome, always having salty food and salts added for seasoning. The independent risks of uncontrolled BP were hypertensive male (OR = 2.48, 95% CI = 1.07-5.76) and metabolic syndrome (OR = 2.59, 95% CI = 1.24-5.40). Males were also at risk for LVH (OR = 2.86, 95% CI = 1.31-6.23) and history of lipid disorders was a risk of microalbuminuria (OR = 3.13, 95% CI = 1.47-6.67).
Males and metabolic syndrome were independently associated with uncontrolled BP in hypertensive participants. Males had more risk than females to develop LVH and having history of lipid disorders lead to microalbuminuria occurrence. Thus, life style modification may prove beneficial to these rural hypertensive participants.
评估泰国农村高血压人群血压控制不佳的相关因素及高血压并发症。
在泰国春武里府纳尧村对年龄≥35岁的泰国农村高血压患者进行了一项横断面研究。测量血压并回答问卷。禁食12小时后，采集血样以测定血糖、血脂谱和血清肌酐。收集晨尿样本进行微量白蛋白尿检测，并进行心电图（ECG）检查以检测左心室肥厚（LVH）。
在289名参与者（97名男性和192名女性）中，高血压平均病程为4.29±4.95年，61.5%未达到血压控制目标。在进行了心电图检查和尿液样本检测的参与者中，15.7%表现出左心室肥厚，25.3%有微量白蛋白尿。血压未得到控制的参与者中，20%有左心室肥厚，24.8%有微量白蛋白尿；而血压得到控制的参与者中，7.8%有左心室肥厚，26.1%有微量白蛋白尿。血压控制不佳与男性、血脂异常、糖尿病、腹型肥胖、代谢综合征、经常食用咸味食物和添加盐调味有关。血压控制不佳的独立危险因素为男性高血压患者（OR = 2.48，95%CI = 1.07 - 5.76）和代谢综合征（OR = 2.59，95%CI = 1.24 - 5.40）。男性也有左心室肥厚的风险（OR = 2.86，95%CI = 1.31 - 6.23），血脂紊乱病史是微量白蛋白尿的危险因素（OR = 3.13，95%CI = 1.47 - 6.67）。
男性和代谢综合征与高血压患者血压控制不佳独立相关。男性发生左心室肥厚的风险高于女性，血脂紊乱病史会导致微量白蛋白尿的发生。因此，改变生活方式可能对这些农村高血压患者有益。
