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绝经后西班牙裔女性中高血压前期和高血压的患病率及发病率:妇女健康倡议的结果

Prevalence and incident prehypertension and hypertension in postmenopausal Hispanic women: results from the Women's Health Initiative.

作者信息

Zambrana Ruth E, López Lenny, Dinwiddie Gniesha Y, Ray Roberta M, Phillips Lawrence S, Trevisan Maurizio, Wassertheil-Smoller Sylvia

机构信息

Department of Women's Studies, University of Maryland, College Park, Maryland.

出版信息

Am J Hypertens. 2014 Mar;27(3):372-81. doi: 10.1093/ajh/hpt279. Epub 2014 Jan 30.

Abstract

BACKGROUND

There is a paucity of research on prehypertension and incident hypertension among postmenopausal Hispanic women. The overall objective is to determine the multiple risk factors associated with the prevalence of hypertension status at baseline and incident hypertension at year 3 in postmenopausal Hispanic women.

METHODS

For the analyses in this paper, we included a total of 4,680 Hispanic women who participated in the Women's Health Initiative (WHI), a randomized clinical trial and observational study, at baseline (1994-1998) and at third-year follow-up and for whom blood pressure was measured at year 3 (n = 3,848). Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of hypertension status, defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, to assess the odds of incident hypertension at year 3 of follow-up in association with the factors included in the baseline models.

RESULTS

At year 3 of follow-up, 27.3% of Hispanic women who were normotensive at baseline had progressed to prehypertension, and 9.0% had become hypertensive. Among the prehypertensive participants at baseline, 30.4% had progressed to hypertension. Compared with normotensive Hispanic women, hypertensive participants had a higher number of cardiovascular risk factors: body mass index ≥30 kg/m(2) (OR = 3.76; 95% CI = 3.01-4.71), a family history of diabetes, stroke, and/or myocardial infarction (OR = 1.12; 95% CI 1.03-1.23), treated hypercholesterolemia (OR = 1.57; 95% CI = 1.23-1.99), treated diabetes (OR = 2.04; 95% CI = 1.40-2.97), and a history of cardiovascular disease (OR = 2.04; 95% CI = 1.58-2.64).

CONCLUSIONS

Hispanic women seem to experience an increased risk of incident hypertension in later adulthood. On a practical level, recommendations for preventive care and population-wide adoption of health behaviors, such as community-focused campaigns to engage in physical activity, may contribute to reductions in hypertension risk factors.

CLINICAL TRIALS REGISTRATION

Trial Number NCT00000611.

摘要

背景

关于绝经后西班牙裔女性的高血压前期和新发高血压的研究较少。总体目标是确定与绝经后西班牙裔女性基线时高血压状态的患病率以及第3年新发高血压相关的多种风险因素。

方法

在本文的分析中,我们纳入了总共4680名参与妇女健康倡议(WHI)的西班牙裔女性,这是一项随机临床试验和观察性研究,她们在基线时(1994 - 1998年)以及第3年随访时接受了血压测量(第3年时n = 3848)。多变量逻辑回归模型用于估计高血压状态的比值比(OR)和95%置信区间(CI),高血压状态定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg,以评估随访第3年新发高血压与基线模型中纳入的因素相关的几率。

结果

在随访第3年时,基线时血压正常的西班牙裔女性中有27.3%进展为高血压前期,9.0%发展为高血压。在基线时处于高血压前期的参与者中,30.4%进展为高血压。与血压正常的西班牙裔女性相比,高血压参与者有更多的心血管危险因素:体重指数≥30 kg/m²(OR = 3.76;95% CI = 3.01 - 4.71)、糖尿病、中风和/或心肌梗死家族史(OR = 1.12;95% CI 1.03 - 1.23)、接受治疗的高胆固醇血症(OR = 1.57;95% CI = 1.23 - 1.99)、接受治疗的糖尿病(OR = 2.04;95% CI = 1.40 - 2.97)以及心血管疾病史(OR = 2.04;95% CI = 1.58 - 2.64)。

结论

西班牙裔女性在成年后期似乎发生新发高血压的风险增加。在实际层面上,关于预防性护理的建议以及在人群中广泛采用健康行为,如以社区为重点开展促进身体活动的运动,可能有助于降低高血压风险因素。

临床试验注册

试验编号NCT00000611。

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