Johnson Heather M, Bartels Christie M, Thorpe Carolyn T, Schumacher Jessica R, Pandhi Nancy, Smith Maureen A
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI.
J Clin Hypertens (Greenwich). 2015 Nov;17(11):885-94. doi: 10.1111/jch.12596. Epub 2015 Jun 13.
Differential rates of diagnosis and treatment by hypertension (HTN) type may contribute to poor HTN control in young adults. The objective of this study was to compare rates of receiving a hypertension diagnosis and antihypertensive agent among young adults with (1) isolated systolic, (2) isolated diastolic, and (3) combined systolic/diastolic HTN. A retrospective analysis was conducted in patients aged 18 to 39 years (n=3003) with incident HTN. Kaplan-Meier survival and Cox proportional hazards analyses were performed. Only 56% with isolated systolic HTN received a diagnosis compared with 63% (systolic/diastolic); 32% with isolated systolic HTN received an initial antihypertensive compared with 52% (systolic/diastolic). Compared with patients with systolic/diastolic HTN, those with isolated systolic HTN had a 50% slower diagnosis rate (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.41-0.60) and those with isolated diastolic HTN had a 26% slower rate (HR, 0.74; CI, 0.60-0.92). Patients with isolated systolic HTN had 58% slower medication initiation (HR, 0.42; CI, 0.34-0.51) and those with isolated diastolic HTN had 31% slower rates (HR, 0.69; CI, 0.55-0.86). Young adults with isolated systolic HTN have lower diagnosis and treatment rates.
按高血压（HTN）类型划分的不同诊断和治疗率可能导致年轻成年人的高血压控制不佳。本研究的目的是比较患有（1）单纯收缩期、（2）单纯舒张期和（3）收缩期/舒张期合并高血压的年轻成年人中接受高血压诊断和抗高血压药物治疗的比例。对年龄在18至39岁（n = 3003）的新发高血压患者进行了回顾性分析。进行了Kaplan-Meier生存分析和Cox比例风险分析。单纯收缩期高血压患者中只有56%得到诊断，而收缩期/舒张期高血压患者为63%；单纯收缩期高血压患者中32%开始接受初始抗高血压治疗，而收缩期/舒张期高血压患者为52%。与收缩期/舒张期高血压患者相比，单纯收缩期高血压患者的诊断率慢50%（风险比[HR]，0.50；95%置信区间[CI]，0.41 - 0.60），单纯舒张期高血压患者的诊断率慢26%（HR，0.74；CI，0.60 - 0.92）。单纯收缩期高血压患者开始用药的速度慢58%（HR，0.42；CI，0.34 - 0.51），单纯舒张期高血压患者的用药速度慢31%（HR，0.69；CI，0.55 - 0.86）。患有单纯收缩期高血压的年轻成年人的诊断和治疗率较低。
