1983-2009 年立陶宛城市中年人群高血压患病率、知晓率、治疗率和控制率的变化趋势及其死亡率风险。
Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983-2009.
机构信息
Department of Population Studies, Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu 17, Kaunas, LT-50140, Lithuanian.
出版信息
BMC Cardiovasc Disord. 2012 Aug 31;12:68. doi: 10.1186/1471-2261-12-68.
BACKGROUND
Arterial hypertension (AH) is a main risk factor for the risk from cardiovascular (CVD) and stroke mortality. Only few data was published on prevalence, awareness and management of AH in Lithuania. Development of objective approaches to the treatment and control of AH reduces the risk of mortality. The aim of this study was to evaluate time trends, the prevalence, awareness, treatment and control of AH and risk of mortality among Lithuanian urban population aged 45-64 years during the period of 1983-2009.
METHODS
Time trends of AH and risk of mortality were examined in three MONICA health surveys in 1983, 1986, 1992, and in one health survey according to MONICA protocol in 2002 included randomly recruited of 2,218 men and 2,491 women. AH was defined as systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP of ≥90 mmHg or current use of antihypertensive medication. The main outcome measures were all-cause mortality, mortality from CVD, coronary heart disease (CHD) and stroke. The mean duration of follow-up was 11.8 ± 9.2 years. All survey periods were age standardized to the year 2006 of Kaunas population. The estimates of hazard ratio and 95% confidence interval were based on the multivariate Cox proportional hazards regression.
RESULTS
In men during 1983-2002 period hypertension prevalence was 52.1-58.7% and did not significantly change whereas in women decreased from 61.0 to 51.0%. There was a significant increase in hypertension awareness among hypertensive men and women (45.0 to 64.4% and 47.7 to 72.3%, respectively) and in treated hypertensives (55.4 to 68.3% in men and 65.6 to 86.2% in women). Adjusted Cox proportional hazard regression analyses revealed a strong dose-response association between blood-pressure level and all-cause, CVD, CHD and stroke-mortality risk in both men and women groups.
CONCLUSION
In Lithuanian urban population the prevalence of hypertension remains high. Despite positive changes in hypertension awareness and treatment, hypertension control remains poor. A strong dose-response association between the level of BP and all-cause, CVD, CHD and stroke mortality risk was indicated.
背景
动脉高血压（AH）是心血管疾病（CVD）和中风死亡风险的主要危险因素。在立陶宛，仅有少量数据报道了 AH 的患病率、知晓率和管理情况。采用客观方法治疗和控制 AH 可降低死亡率。本研究旨在评估 1983 年至 2009 年期间立陶宛城市 45-64 岁人群 AH 的时间趋势、患病率、知晓率、治疗和控制情况以及死亡率风险。
方法
采用 1983 年、1986 年、1992 年三次 MONICA 健康调查和 2002 年按照 MONICA 方案进行的一次健康调查，对 AH 和死亡率风险的时间趋势进行了评估。该调查随机招募了 2218 名男性和 2491 名女性。AH 的定义为收缩压（BP）≥140mmHg 和/或舒张压≥90mmHg，或正在使用降压药物。主要观察指标为全因死亡率、CVD 死亡率、冠心病（CHD）死亡率和中风死亡率。平均随访时间为 11.8±9.2 年。所有调查时期均按照 2006 年考纳斯人口年龄标准化。风险比和 95%置信区间的估计值基于多变量 Cox 比例风险回归。
结果
1983 年至 2002 年期间，男性高血压患病率为 52.1%-58.7%，无显著变化，而女性患病率则从 61.0%降至 51.0%。男性和女性高血压患者的知晓率（分别从 45.0%增至 64.4%和从 47.7%增至 72.3%）以及治疗中的高血压患者比例（男性从 55.4%增至 68.3%，女性从 65.6%增至 86.2%）均显著增加。校正后的 Cox 比例风险回归分析显示，男性和女性人群的血压水平与全因、CVD、CHD 和中风死亡率风险之间存在明显的剂量反应关系。
结论
立陶宛城市人群高血压患病率仍然较高。尽管高血压知晓率和治疗率有所改善，但血压控制仍不理想。血压水平与全因、CVD、CHD 和中风死亡率风险之间存在明显的剂量反应关系。
Zotero 插件