Salomaa V, Tuomilehto J, Nissinen A, Korhonen H J, Vartiainen E, Kartovaara L, Puska P
Department of Epidemiology, National Public Helath Institutes, Helsinki, Finland.
J Hypertens. 1989 Oct;7(10):837-44. doi: 10.1097/00004872-198910000-00009.
The development of hypertension care in Finland was evaluated using the data from two independent population samples of the FINMONICA Project comprising 9350 and 6250 persons examined in 1982 and 1987, respectively. The sampling frame was the population aged 25 to 64 years in the provinces of North Karelia and Kuopio in eastern Finland and in the Turku-Loimaa region in south-western Finland. During the 5-year period, the mean systolic blood pressure levels decreased in all of the groups except the North Karelian men. Mean diastolic blood pressure did not change significantly. The proportion of hypertensive men with adequately controlled blood pressure increased from 22.6 to 29.4% [difference 6.8%, 95% confidence interval (Cl) for the difference 2.4-11.2] during 1982-1987. At the same time, the proportion of hypertensive men unaware of their condition fell from 30 to 20.9% (difference -9.1%, 95% Cl for the difference -13.4- -4.8). There was corresponding falls for women from 39.2 to 41.3% (difference 2.1%, 95% Cl for the difference -3.1-7.3) and from 15.4 to 13.1% (difference -2.3%, 95% Cl for the difference 1.4- -6.0), respectively. Thus, obvious progress had taken place, although the situation remained far from satisfactory. The possibility of overly aggressive treatment of hypertension was also investigated. It was found that only less than 10% of the middle-aged hypertensive men treated with drugs had diastolic pressures less than or equal to 85 mmHg, suggesting that this might not be an issue of concern at community level.
利用芬兰全国心血管病监测(FINMONICA)项目中两个独立人群样本的数据,对芬兰高血压护理的发展情况进行了评估。这两个样本分别包含1982年和1987年接受检查的9350人和6250人。抽样框架为芬兰东部北卡累利阿省和库奥皮奥省以及芬兰西南部图尔库-洛马地区25至64岁的人群。在这5年期间,除北卡累利阿省男性外,所有组的平均收缩压水平均有所下降。平均舒张压没有显著变化。1982 - 1987年期间,血压得到充分控制的高血压男性比例从22.6%增至29.4%[差值6.8%,差值的95%置信区间(Cl)为2.4 - 11.2]。与此同时,未意识到自己患有高血压的男性比例从30%降至20.9%(差值 -9.1%,差值的95% Cl为 -13.4 - -4.8)。女性的相应比例分别从39.2%降至41.3%(差值2.1%,差值的95% Cl为 -3.1 - 7.3)以及从15.4%降至13.1%(差值 -2.3%,差值的95% Cl为1.4 - -6.0)。因此,尽管情况仍远未令人满意,但已取得明显进展。还对高血压过度积极治疗的可能性进行了调查。结果发现,接受药物治疗的中年高血压男性中,只有不到10%的人舒张压小于或等于85 mmHg,这表明在社区层面这可能不是一个值得关注的问题。