Nephrology and Dialysis Unit, San Carlo Borromeo Hospital, Graduate School of Nephrology, University of Milan, Milan, Italy; Project for People, Milan, Italy.
Nephrology (Carlton). 2013 Dec;18(12):798-807. doi: 10.1111/nep.12142.
Hypertension (HTN) and chronic kidney disease (CKD) are important emerging problems in low-income countries, with an increasing number of patients dying from their consequences.
A project for investigating these issues was carried out in West Bengal, India, in 2536 adult subjects. Body mass index (BMI) was classified using traditional and new cut-offs identified by the World Health Organization for Asian populations. HTN was classified according to the Joint National Committee 7 and CKD according to presence of estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m(2) .
Normal BMI (Asian reference) was found in 41.5% of subjects, while 33.4% were underweight, 19.3% overweight and 5.8% obese. Prevalence of stage 1 and 2 HTN was 39.4%. Proteinuria (urine dipstick >1+) was present in 7.7% of the sample. In a subsample of 1526 subjects, eGFR of less than 60 mL/min per 1.73 m(2) was found in 4.2%. At multivariate analysis, factors associated with HTN were weight classes (P<0.001), presence of proteinuria (P<0.001) and family history of HTN (P=0.028), while living in rural areas was associated with lower risk for HTN (P=0.003). eGFR was inversely related to BMI (P=0.03), the presence of proteinuria (P<0.001) and HTN (P<0.003), and directly related to living in rural areas (P=0.003).
High prevalence of HTN was found in subjects with very limited access to health care in West Bengal. HTN was more common in overweight individuals, but also affected normal weight and underweight subjects in a significant part of the tested population. Preventive medicine should be a strong priority in this setting.
高血压（HTN）和慢性肾脏病（CKD）是低收入国家日益严重的新兴问题，越来越多的患者死于这些疾病的后果。
在印度西孟加拉邦进行了一项调查这些问题的项目，共纳入 2536 名成年受试者。体重指数（BMI）采用世界卫生组织（WHO）为亚洲人群确定的传统和新切点进行分类。高血压根据美国联合委员会第 7 次报告进行分类，CKD 根据估计肾小球滤过率（eGFR）<60ml/min/1.73m2 进行分类。
41.5%的受试者BMI 正常（亚洲参考值），33.4%体重不足，19.3%超重，5.8%肥胖。1 期和 2 期高血压的患病率为 39.4%。尿液试纸法检测蛋白尿（>1+）的发生率为 7.7%。在 1526 名受试者的亚组中，有 4.2%的 eGFR<60ml/min/1.73m2。多变量分析显示，与高血压相关的因素有体重指数（P<0.001）、蛋白尿的存在（P<0.001）和高血压家族史（P=0.028），而居住在农村地区与高血压风险较低相关（P=0.003）。eGFR 与 BMI 呈负相关（P=0.03），与蛋白尿（P<0.001）和高血压（P<0.003）呈负相关，与居住在农村地区呈正相关（P=0.003）。
在西孟加拉邦，卫生保健资源非常有限的受试者中，高血压的患病率很高。超重者高血压更为常见，但在相当一部分受检人群中，正常体重和体重不足者也受到高血压的影响。在这种情况下，预防医学应成为重中之重。
