a School of Health Sciences , Wuhan University , Wuhan , China.
b Department of Chronic Disease Control , Hubei Provincial Center for Disease Control and Prevention , Wuhan , China.
Clin Exp Hypertens. 2017;39(6):532-538. doi: 10.1080/10641963.2017.1281948. Epub 2017 Jun 7.
Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions.
This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension.
The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623-0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women.
The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.
尽管为了扭转这一趋势付出了巨大努力，但高血压仍占全球疾病负担的 7%。因此，针对高血压前期的干预措施可能会成为高血压预防的一个突破点。本研究聚焦于中国中部成年人高血压前期的患病率以及高血压前期的最佳预测指标，为未来的干预措施提供依据。
本横断面研究采用多阶段分层随机抽样方法，在湖北省的 7 个县进行。使用逻辑回归和受试者工作特征（ROC）曲线统计检验对 30634 名调查对象的数据进行分析，以评估高血压前期的患病率以及体重指数（BMI）、腰高比（WHtR）和腰围（WC）对高血压前期的预测能力。
成年人高血压前期的患病率为 42.2%。以下因素与高血压前期的风险相关：男性、年龄较大、离婚/分居、饮酒、重体力劳动强度和较高的 BMI（p<0.05）。农民和运动与高血压前期呈正相关（p<0.05）。与 BMI 和 WHtR 相比，WC 对高血压前期具有更高的预测价值（ROC 曲线下面积，AUC=0.630，95%置信区间：0.623-0.637，p<0.0001），特别是对男性而言。男性 WC 的最佳高血压前期切点值为 79.95cm，女性为 76.85cm。
中国中部成年人高血压前期的患病率较高。确定了与高血压相关的显著因素。需要针对 WC 超过临界值的个体进行更多的干预，以提高对高血压前期的认识并进行早期高血压预防。
