aCardiovascular Research Center bCardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan cDepartment of Neurology, Tehran University of Medical Sciences, Tehran, Iran dSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
J Hypertens. 2014 Jan;32(1):30-8. doi: 10.1097/HJH.0b013e32836591d4.
The present study aimed to investigate the incidence and predictors of hypertension in an Iranian adult population.
Isfahan Cohort Study was a longitudinal population-based study that was conducted on adults aged 35 years or older, living in urban and rural areas of three districts in central Iran. After 7 years of follow-up, 3283 participants were re-evaluated using a standard protocol similar to the baseline. At both measurements, participants underwent medical interview, physical examination, and fasting blood measurements. Participants (n = 833) with prevalent hypertension were excluded from the analysis, resulting in a sample size of 2450.
The participants' age was 47.3 ± 9.4 years (mean ± SD) and 50.7% were men. During the follow-up period, 542 (22.1%) individuals developed hypertension, 49.6% of whom were aware of their disease, 42.4% were treated, but only 24.9% were controlled. Incidence rates have shown no sex-specific difference across age and blood pressure (BP) categories. Multivariate-adjusted model controlled for all study covariates showed that age, male sex, general and central obesity, hypertriglyceridemia, impaired fasting glucose, diabetes mellitus, baseline BP at least 120/80 mmHg (nonoptimal BP), and parental history of hypertension independently contributed to the development of hypertension. Higher education level and more than 10% decrease in waist circumference over 7-year follow-up represented protective effects. In men, weight loss decreased and weight gain increased the risk of developing hypertension. Nonoptimal BP along with central obesity and hypertriglyceridemia together were responsible for 71% of the burden of hypertension.
Our findings imply that there are other factors in addition to nonoptimal BP that deserve integrating into the risk assessment criteria for developing hypertension.
本研究旨在调查伊朗成年人群高血压的发病率和预测因素。
伊斯法罕队列研究是一项基于人群的纵向研究，纳入了居住在伊朗中部三个区城乡地区的 35 岁及以上成年人。经过 7 年的随访，3283 名参与者采用与基线相似的标准方案进行了重新评估。在两次测量中，参与者均接受了医学访谈、体格检查和空腹血样测量。将患有高血压的 833 名参与者（即已患病人群）排除在分析之外，最终样本量为 2450 名。
参与者的年龄为 47.3±9.4 岁（均值±标准差），50.7%为男性。在随访期间，542 名（22.1%）参与者发生了高血压，其中 49.6%的人知晓自己患有高血压，42.4%的人接受了治疗，但仅有 24.9%的人得到了控制。在不同年龄和血压（BP）组中，发病率在性别间无差异。经多变量校正模型控制了所有研究协变量后显示，年龄、男性、全身性和中心性肥胖、高甘油三酯血症、空腹血糖受损、糖尿病、基线至少 120/80mmHg 的 BP（非理想 BP）以及父母高血压病史独立促成了高血压的发生。较高的教育水平和 7 年随访期间腰围减少 10%以上代表了保护作用。在男性中，体重减轻降低了高血压发生风险，而体重增加增加了高血压发生风险。非理想 BP 与中心性肥胖和高甘油三酯血症共同导致了 71%的高血压负担。
我们的研究结果表明，除了非理想 BP 外，还有其他因素值得纳入高血压发生风险评估标准中。
