Booth John N, Li Jiexiang, Zhang Lu, Chen Liwei, Muntner Paul, Egan Brent
From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.).
Hypertension. 2017 Aug;70(2):275-284. doi: 10.1161/HYPERTENSIONAHA.116.09004. Epub 2017 Jun 12.
Prehypertension is associated with increased risk for hypertension and cardiovascular disease. Data are limited on the temporal changes in the prevalence of prehypertension and risk factors for hypertension and cardiovascular disease among US adults with prehypertension. We analyzed data from 30 958 US adults ≥20 years of age who participated in the National Health and Nutrition Examination Surveys between 1999 and 2012. Using the mean of 3 blood pressure (BP) measurements from a study examination, prehypertension was defined as systolic BP of 120 to 139 mm Hg and diastolic BP <90 mm Hg or diastolic BP of 80 to 89 mm Hg and systolic BP <140 mm Hg among participants not taking antihypertensive medication. Between 1999-2000 and 2011-2012, the percentage of US adults with prehypertension decreased from 31.2% to 28.2% ( trend=0.007). During this time period, the prevalence of several risk factors for cardiovascular disease and incident hypertension increased among US adults with prehypertension, including prediabetes (9.6% to 21.6%), diabetes mellitus (6.0% to 8.5%), overweight (33.5% to 37.3%), and obesity (30.6% to 35.2%). There was a nonstatistically significant increase in no weekly leisure-time physical activity (40.0% to 43.9%). Also, the prevalence of adhering to the Dietary Approaches to Stop Hypertension eating pattern decreased (18.4% to 11.9%). In contrast, there was a nonstatistically significant decline in current smoking (25.9% to 23.2%). In conclusion, the prevalence of prehypertension has decreased modestly since 1999-2000. Population-level approaches directed at adults with prehypertension are needed to improve risk factors to prevent hypertension and cardiovascular disease.
高血压前期与高血压及心血管疾病风险增加相关。关于美国高血压前期成年人中高血压前期患病率以及高血压和心血管疾病危险因素的时间变化的数据有限。我们分析了1999年至2012年间参加国家健康和营养检查调查的30958名年龄≥20岁的美国成年人的数据。根据研究检查中3次血压（BP）测量的平均值，在未服用抗高血压药物的参与者中，高血压前期定义为收缩压120至139毫米汞柱且舒张压<90毫米汞柱，或舒张压80至89毫米汞柱且收缩压<140毫米汞柱。在1999 - 2000年至2011 - 2012年期间，美国高血压前期成年人的比例从31.2%降至28.2%（趋势 = 0.007）。在此期间，美国高血压前期成年人中几种心血管疾病和新发高血压危险因素的患病率有所增加，包括糖尿病前期（从9.6%增至21.6%）、糖尿病（从6.0%增至8.5%）、超重（从33.5%增至37.3%）和肥胖（从30.6%增至35.2%）。每周无休闲时间体育活动的情况有非统计学意义的增加（从40.0%增至43.9%）。此外，遵循终止高血压饮食模式的患病率下降（从18.4%降至11.9%）。相比之下，当前吸烟率有非统计学意义的下降（从25.9%降至23.2%）。总之，自1999 - 2000年以来，高血压前期患病率略有下降。需要针对高血压前期成年人采取人群层面的措施来改善危险因素，以预防高血压和心血管疾病。
