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欧洲血压的泛种族差异：一项系统评价与荟萃分析

Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis.

作者信息

Modesti Pietro Amedeo, Reboldi Gianpaolo, Cappuccio Francesco P, Agyemang Charles, Remuzzi Giuseppe, Rapi Stefano, Perruolo Eleonora, Parati Gianfranco

机构信息

Dept of Medicina Sperimentale e Clinica, University of Florence, Florence, Italy.

Dept of Medicine, University of Perugia, Perugia, Italy.

出版信息

PLoS One. 2016 Jan 25;11(1):e0147601. doi: 10.1371/journal.pone.0147601. eCollection 2016.

DOI:10.1371/journal.pone.0147601
PMID:26808317
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4725677/
Abstract

BACKGROUND

People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU.

METHODS AND FINDINGS

We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence.

CONCLUSIONS

  1. The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.
摘要

背景

生活在欧洲的撒哈拉以南非洲（SSA）和南亚（SA）少数民族比欧洲本土人（EU）患中风的风险更高。研究目的是评估SSA、SA和EU之间诊室收缩压（SBP）和舒张压（DBP）水平在性别上的绝对差异。

方法与结果

我们对在欧洲进行的观察性研究进行了系统综述和荟萃分析，这些研究对未经过挑选的成年SSA、SA和EU受试者的血压进行了检测。从数据库建立到2015年1月31日，检索了Medline、PubMed、Embase、Web of Science和Scopus以查找相关文章。使用随机效应模型并对异质性进行检验，结果指标为少数民族与EU之间的平均SBP和DBP差异。纳入了21项研究，涉及9070名SSA受试者、18421名SA受试者和130380名EU受试者。与EU相比，SSA的SBP（男性和女性分别为3.38 mmHg，95%置信区间1.28至5.48 mmHg；以及6.00 mmHg，95%置信区间2.22至9.78 mmHg）和DBP（3.29 mmHg，95%置信区间1.80至4.78；5.35 mmHg，95%置信区间3.04至7.66）值均更高。SA的SBP低于EU（-4.57 mmHg，95%置信区间-6.20至-2.93；-2.97 mmHg，95%置信区间-5.45至-0.49），但DBP值相似。亚组荟萃分析表明，来自以伊斯兰教为主要宗教的国家的SA的SBP和DBP值低于EU。在多变量荟萃回归分析中，少数民族与EU人群之间的SBP差异受泛种族和糖尿病患病率影响。

结论

1）SSA人群较高的血压水平持续了数十年，这表明欧洲针对该群体的预防策略效果有限；2）穆斯林人群较低的血压表明，尚未被挖掘的生活方式和行为习惯可能对高血压的发展具有优势；3）糖尿病的叠加效应强调了在糖尿病高患病率群体中需要新的高血压控制策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/30a26d274f4b/pone.0147601.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/5682f356d971/pone.0147601.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/198ef53b32c5/pone.0147601.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/a55388c9a748/pone.0147601.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/fb821bfa062e/pone.0147601.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/30a26d274f4b/pone.0147601.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/5682f356d971/pone.0147601.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/198ef53b32c5/pone.0147601.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/a55388c9a748/pone.0147601.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/fb821bfa062e/pone.0147601.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c45/4725677/30a26d274f4b/pone.0147601.g005.jpg

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