Chiang Peggy P C, Lamoureux Ecosse L, Shankar Anoop, Tai E Shyong, Wong Tien Y, Sabanayagam Charumathi
Singapore Eye Research Institute, Singapore National Eye Centre, Level 6, 11 Third Hospital Avenue, Singapore 168751, Singapore.
BMC Public Health. 2013 Aug 7;13:730. doi: 10.1186/1471-2458-13-730.
Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.
We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders.
The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables.
Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
高血压前期已被证明是心血管疾病（CVD）的早期危险因素。我们调查了新加坡三个亚洲种族人群中高血压前期患者的心血管代谢危险因素的患病率和模式。
我们研究了来自中国（n = 1177）、马来（n = 774）和印度（n = 985）40 - 80岁成年人的数据，这些人参与了2004年至2011年在新加坡进行的三项独立的基于人群的研究，且均无糖尿病、高血压和既往心血管疾病史。高血压前期定义为收缩压（BP）120 - 139 mmHg或舒张压80 - 89 mmHg。随机血糖、糖化血红蛋白（HbA1c）、体重指数（BMI）、甘油三酯、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）胆固醇被作为不良心血管代谢状况的指标进行检测。使用逻辑回归模型调整潜在混杂因素后，研究代谢变量与高血压前期之间的关联。
高血压前期的患病率分别为59.8%（中国人）、68.9%（马来人）和57.7%（印度人）。在所有三个种族群体中，较高水平的血糖、HbA1c和BMI与高血压前期显著相关，中国、马来和印度人群中高血压前期的比值比（95%置信区间）分别为：高血糖时为1.42（1.10，1.83）、1.53（1.05，2.24）、1.49（1.13，1.98）；高HbA1c时为3.50（1.01，12.18）、3.72（1.29，10.75）、2.79（1.31，5.94）；高BMI时为1.86（1.34，2.56）、2.96（2.10，4.18）、1.68（1.28，2.20）。此外，中国人中较高水平的低密度脂蛋白胆固醇和较高水平的甘油三酯与高血压前期显著相关。当将代谢变量作为连续变量分析时，这些关联依然存在。
在新加坡的所有三个种族群体中，较高水平的血糖、HbA1c和BMI与高血压前期相关。对高血压前期进行筛查和改变生活方式可能会减轻居住在新加坡的健康亚洲成年人的心血管疾病负担。
