印度国家首都地区20年间高血压患病率、知晓率、治疗率和控制率的变化：一项重复横断面研究的结果
Changes in hypertension prevalence, awareness, treatment and control rates over 20 years in National Capital Region of India: results from a repeat cross-sectional study.
作者信息
Roy Ambuj, Praveen Pradeep A, Amarchand Ritvik, Ramakrishnan Lakshmy, Gupta Ruby, Kondal Dimple, Singh Kalpana, Sharma Meenakshi, Shukla Deepak Kumar, Tandon Nikhil, Reddy Kolli Srinath, Krishnan Anand, Prabhakaran Dorairaj
机构信息
Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
出版信息
BMJ Open. 2017 Jul 12;7(7):e015639. doi: 10.1136/bmjopen-2016-015639.
BACKGROUND AND OBJECTIVES
Despite being one of the leading risk factors of cardiovascular mortality, there are limited data on changes in hypertension burden and management from India. This study evaluates trend in the prevalence, awareness, treatment and control of hypertension in the urban and rural areas of India's National Capital Region (NCR).
DESIGN AND SETTING
Two representative cross-sectional surveys were conducted in urban and rural areas (survey 1 (1991-1994); survey 2 (2010-2012)) of NCR using similar methodologies.
PARTICIPANTS
A total of 3048 (mean age: 46.8±9.0 years; 52.3% women) and 2052 (mean age: 46.5±8.4 years; 54.2% women) subjects of urban areas and 2487 (mean age: 46.6±8.8 years; 57.0% women) and 1917 (mean age: 46.5±8.5 years; 51.3% women) subjects of rural areas were included in survey 1 and survey 2, respectively.
PRIMARY AND SECONDARY OUTCOME MEASURES
Hypertension was defined as per Joint National Committee VII guidelines. Structured questionnaire was used to measure the awareness and treatment status of hypertension. A mean systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg was defined as control of hypertension among the participants with hypertension.
RESULTS
The age and sex standardised prevalence of hypertension increased from 23.0% to 42.2% (p<0.001) and 11.2% to 28.9% (p<0.001) in urban and rural NCR, respectively. In both surveys, those with high education, alcohol use, obesity and high fasting blood glucose were at a higher risk for hypertension. However, the change in hypertension prevalence between the surveys was independent of these risk factors (adjusted OR (95% CI): urban (2.3 (2.0 to 2.7)) rural (3.1 (2.4 to 4.0))). Overall, there was no improvement in awareness, treatment and control rates of hypertension in the population.
CONCLUSION
There was marked increase in prevalence of hypertension over two decades with no improvement in management.
背景与目的
尽管高血压是心血管疾病死亡的主要危险因素之一，但关于印度高血压负担和管理变化的数据有限。本研究评估了印度国家首都地区（NCR）城乡高血压患病率、知晓率、治疗率和控制率的趋势。
设计与背景
在NCR的城乡地区进行了两项具有代表性的横断面调查（调查1（1991 - 1994年）；调查2（2010 - 2012年）），采用相似的方法。
参与者
调查1分别纳入了3048名城市地区受试者（平均年龄：46.8±9.0岁；女性占52.3%）和2487名农村地区受试者（平均年龄：46.6±8.8岁；女性占57.0%）；调查2分别纳入了2052名城市地区受试者（平均年龄：46.5±8.4岁；女性占54.2%）和1917名农村地区受试者（平均年龄：46.5±8.5岁；女性占51.3%）。
主要和次要观察指标
高血压根据美国国家联合委员会第七版指南定义。使用结构化问卷测量高血压的知晓和治疗情况。对于患有高血压的参与者，平均收缩压<140 mmHg且舒张压<90 mmHg被定义为高血压得到控制。
结果
NCR城乡地区年龄和性别标准化的高血压患病率分别从23.0%升至42.2%（p<0.001）和从11.2%升至28.9%（p<0.001）。在两项调查中，受过高等教育、饮酒、肥胖和空腹血糖高的人群患高血压风险更高。然而，两次调查之间高血压患病率的变化与这些危险因素无关（调整后的比值比（95%置信区间）：城市（2.3（2.0至2.7）），农村（3.1（2.4至4.0）））。总体而言，人群中高血压的知晓率、治疗率和控制率没有改善。
结论
二十年间高血压患病率显著上升，但管理方面没有改善。
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