Steenkamp H J, Jooste P L, Chalton D O, Rossouw J E, Benadé A J, Steyn M
Research Institute for Nutritional Diseases, South African Medical Research Council, Parowvallei, CP.
S Afr Med J. 1990 Jul 21;78(2):89-93.
The association between hypertension and coronary risk factors and the effect of antihypertensive treatment on coronary risk were investigated in rural South African whites aged 15-64 years. Almost 25% of men (range 1.9-46.6%) and almost 27% of women (2.1-56.2%) were hypertensive or being treated for hypertension; the prevalence increased with age, particularly among women. Only 25.8% of male and 43.4% of female hypertensives were being treated, and of these only 38% had controlled blood pressure. Hypertension was associated with a high serum total cholesterol level, a low high-density lipoprotein cholesterol level, a high body mass index, a high uric acid level, a high prevalence of coronary heart disease and, in men, high alcohol consumption. Treated hypertensives had a greater risk of coronary heart disease than untreated hypertensives. Men on beta-blockers had significantly lower high-density lipoprotein cholesterol levels than men not on treatment, while uric acid levels in both men and women on diuretics were higher than those of untreated hypertensives. Hypertension in the study population appears to be inadequately treated, and antihypertensive medication may impact adversely on metabolic risk factors. The goal of antihypertensive therapy should be a net reduction of coronary heart disease risk.
对南非农村地区15至64岁的白人进行了高血压与冠心病危险因素之间的关联以及降压治疗对冠心病风险影响的研究。近25%的男性（范围为1.9% - 46.6%）和近27%的女性（2.1% - 56.2%）患有高血压或正在接受高血压治疗；患病率随年龄增长而增加，尤其是在女性中。只有25.8%的男性高血压患者和43.4%的女性高血压患者正在接受治疗，其中只有38%的患者血压得到控制。高血压与高血清总胆固醇水平、低高密度脂蛋白胆固醇水平、高体重指数、高尿酸水平、冠心病高患病率相关，在男性中还与高酒精摄入量相关。接受治疗的高血压患者患冠心病的风险比未接受治疗的高血压患者更高。服用β受体阻滞剂的男性高密度脂蛋白胆固醇水平显著低于未接受治疗的男性，而服用利尿剂的男性和女性的尿酸水平均高于未接受治疗的高血压患者。该研究人群中的高血压似乎未得到充分治疗，降压药物可能会对代谢危险因素产生不利影响。降压治疗的目标应该是净降低冠心病风险。
