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荷兰长期脊髓损伤患者的高血压患病率及相关危险因素

Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands.

作者信息

Adriaansen Jacinthe J E, Douma-Haan Yvonne, van Asbeck Floris W A, van Koppenhagen Casper F, de Groot Sonja, Smit Christof A, Visser-Meily Johanna M A, Post Marcel W M

机构信息

a Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, De Hoogstraat Rehabilitation and University Medical Center Utrecht , Utrecht , The Netherlands.

b Spinal Cord Injury Department , De Hoogstraat Rehabilitation , Utrecht , The Netherlands.

出版信息

Disabil Rehabil. 2017 May;39(9):919-927. doi: 10.3109/09638288.2016.1172349. Epub 2016 May 9.

Abstract

PURPOSE

To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population.

METHOD

Multicentre cross-sectional study (N = 282). Hypertension was defined as a systolic blood pressure (SBP) of ≥140 mmHg and/or a diastolic blood pressure (DBP) of ≥90 mmHg after ≥2 blood pressure measurements during ≥2 doctor visits. High blood pressure was defined as a single measurement of a SBP of ≥140 mmHg and/or a DBP of ≥90 mmHg.

RESULTS

The prevalence of hypertension was 21.5%. Significant predictors were: lesion level below C8 (T1-T6: OR =6.4, T7-L5: OR =10.1), history of hypercholesterolemia (OR =4.8), longer time since injury (OR =1.1), higher age (OR =1.1). The prevalence of high blood pressure and/or the use of antihypertensive drugs was higher in men (T1-T6 lesion: 48%; T7-L5 lesion: 57%) and women (T1-T6 lesion: 48%; T7-L5 lesion: 25%) with a SCI below C8 compared to Dutch able-bodied men (31%) and women (18%).

CONCLUSION

High blood pressure is common in people with SCI. Screening for hypertension during annual checkups is recommended, especially in those with a SCI below C8. Implications for Rehabilitation High blood pressure is common in people with long-term SCI living in the Netherlands and its prevalence is higher in both men and women with a spinal cord lesion level below C8 compared with the age-matched Dutch general population. It is recommended to screen for hypertension during annual checkups in people with SCI, especially in those with a higher risk of developing hypertension, e.g. those with a spinal cord lesion level below C8 and an age of ≥45 years or a time since injury of ≥20 years. When a high blood pressure is measured in people with SCI, they should receive a further assessment of the blood pressure according to the available guidelines for the general population, including ambulatory 24 h-blood pressure monitoring.

摘要

目的

描述长期脊髓损伤(SCI)患者中高血压及相关危险因素的患病率,并将高血压和/或使用降压药物的患病率与荷兰普通人群进行比较。

方法

多中心横断面研究(N = 282)。高血压定义为在≥2次医生就诊期间进行≥2次血压测量后,收缩压(SBP)≥140 mmHg和/或舒张压(DBP)≥90 mmHg。高血压定义为单次测量SBP≥140 mmHg和/或DBP≥90 mmHg。

结果

高血压患病率为21.5%。显著预测因素为:损伤平面低于C8(T1 - T6:比值比[OR]=6.4,T7 - L5:OR = 10.1)、高胆固醇血症病史(OR = 4.8)、受伤时间较长(OR = 1.1)、年龄较大(OR = 1.1)。与荷兰健全男性(31%)和女性(18%)相比,C8以下脊髓损伤的男性(T1 - T6损伤:48%;T7 - L5损伤:57%)和女性(T1 - T6损伤:48%;T7 - L5损伤:25%)中高血压和/或使用降压药物的患病率更高。

结论

高血压在脊髓损伤患者中很常见。建议在年度体检时筛查高血压,尤其是在C8以下脊髓损伤的患者中。康复的意义高血压在荷兰长期脊髓损伤患者中很常见,与年龄匹配的荷兰普通人群相比,脊髓损伤平面低于C8的男性和女性患病率更高。建议对脊髓损伤患者进行年度体检时筛查高血压,尤其是那些患高血压风险较高的患者,例如脊髓损伤平面低于C8且年龄≥45岁或受伤时间≥20年的患者。当脊髓损伤患者测量到高血压时,应根据普通人群的现有指南对血压进行进一步评估,包括动态24小时血压监测。

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