MMWR Morb Mortal Wkly Rep. 2013 May 10;62(18):351-5.
Hypertension is a leading cause of cardiovascular disease and affects nearly one third of U.S. adults. Because the risk for cardiovascular disease mortality increases as blood pressure increases, clinical recommendations for persons with stage 2 hypertension (systolic blood pressure [SBP] ≥160 mmHg or diastolic blood pressure [DBP] ≥100 mmHg) include a more extensive treatment and follow-up regime than for those with stage 1 hypertension (SBP 140-159 mmHg or DBP 90-99 mmHg). Although racial/ethnic disparities in the prevalence of hypertension have been well documented; ethnic disparities in the awareness, treatment, and control within blood pressure stages have not. To examine racial/ethnic disparities in awareness, treatment, and control of high blood pressure by hypertension stages, CDC analyzed data from the National Health and Nutrition Examination Survey (NHANES) for the period 2003-2010. This report describes the results of that analysis, which indicated that the proportion of Mexican-Americans and blacks with stage 1 and stage 2 hypertension was greater than for whites.* Among those with stage 1 hypertension, treatment with medication was significantly lower for Mexican-Americans compared with their non-Hispanic counterparts. Although treatment among persons with stage 2 hypertension did not differ by race/ethnicity, less than 60% of those with stage 2 hypertension were treated with medication. More efforts are needed to reduce barriers to accessing health care and low-cost medication, as well as increasing clinicians' hypertension treatment knowledge and adherence to clinical guidelines.
高血压是心血管疾病的主要病因,影响了近三分之一的美国成年人。由于心血管疾病死亡率随着血压升高而增加,因此对于 2 期高血压患者(收缩压[SBP]≥160mmHg 或舒张压[DBP]≥100mmHg),临床建议采用更广泛的治疗和随访方案,而不是 1 期高血压患者(SBP 140-159mmHg 或 DBP 90-99mmHg)。尽管种族/民族间高血压患病率的差异已有充分记录,但在血压阶段的知晓率、治疗率和控制率方面,种族/民族间的差异尚未得到研究。为了研究高血压阶段种族/民族间知晓率、治疗率和控制率的差异,疾病预防控制中心分析了 2003-2010 年全国健康和营养调查(NHANES)的数据。本报告介绍了该分析的结果,结果表明,1 期和 2 期高血压患者中,墨西哥裔和非裔美国人的比例高于白人。在 1 期高血压患者中,与非西班牙裔墨西哥裔相比,药物治疗的比例明显较低。尽管 2 期高血压患者的种族/民族之间的治疗方法没有差异,但接受药物治疗的 2 期高血压患者不到 60%。需要进一步努力消除获得医疗保健和低成本药物的障碍,并提高临床医生的高血压治疗知识和对临床指南的遵循。