Han Thang S, Wang Harry Hao-Xiang, Wei Li, Pan Yuesong, Ma Ying, Wang Yu, Wang Jiaji, Hu Zhi, Sharma Pankaj, Chen Ruoling
Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, UK.
Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust, Surrey, UK.
BMJ Open. 2017 Oct 8;7(10):e016581. doi: 10.1136/bmjopen-2017-016581.
China carries the greatest burden of stroke given its largest volume of people with hypertension. This study assessed the impacts of suboptimal controls of hypertension on incident stroke and projected the number of patients with stroke saved after the control of blood pressure improved in population.
Anhui, China.
We examined data from the Anhui cohort of 2001-2011, consisting of 3336 participants aged ≥60 years who were randomly recruited from the urban and rural Anhui. 2852 participants (89.2%) had hypertensive status measured and no stroke at baseline, and were followed up until 2011 in three surveys using a standard method of interview.
At baseline, 1646 participants (57.7%) were identified to have hypertension, among whom 912 (55.4%) were previously undetected, 115 (7.0%) detected but not treated, 452 (27.5%) treated but not controlled and only 127 (7.7%) controlled. During the 10-year follow-up, 211 incident stroke cases (12.8/1000 person-years) occurred. Compared with normotensive individuals at baseline, multivariate adjusted HR for having stroke increased in those with undetected hypertension by 1.63 (95%CI 1.15 to 2.32), untreated by 2.21 (1.26-3.85) and uncontrolled hypertension by 3.34 (2.28-4.88), but did not differ from those with controlled hypertension (1.34; 0.60-2.99). Based on a two-fold increase in the detection and management of current levels of hypertension and algorithms on the current situation in China, approximately 250 000 incident stroke cases could be prevented annually.
In China, hypertension is frequently undetected or inadequately treated. With appropriate management of hypertension, a substantial number of people could be saved form stroke.
鉴于中国高血压患者数量众多，其承担着全球最大的中风负担。本研究评估了高血压控制不佳对中风发病的影响，并预测了人群血压控制改善后可挽救的中风患者数量。
中国安徽。
我们研究了2001年至2011年安徽队列的数据，该队列由3336名年龄≥60岁的参与者组成，他们是从安徽城乡随机招募的。2852名参与者（89.2%）在基线时测量了高血压状态且无中风，通过标准访谈方法在三次调查中随访至2011年。
在基线时，1646名参与者（57.7%）被确定患有高血压，其中912名（55.4%）此前未被发现，115名（7.0%）被发现但未治疗，452名（27.5%）接受了治疗但未得到控制，只有127名（7.7%）得到了控制。在10年的随访期间，发生了211例中风病例（12.8/1000人年）。与基线时的血压正常个体相比，未被发现的高血压患者发生中风的多变量调整风险比增加了1.63（95%CI 1.15至2.32），未治疗的增加了2.21（1.26 - 3.85），未得到控制的高血压患者增加了3.34（2.28 - 4.88），但与得到控制的高血压患者无差异（1.34；0.60 - 2.99）。基于目前中国高血压检测和管理水平的两倍增长以及当前情况的算法，每年大约可以预防250000例中风病例。
在中国，高血压常常未被发现或治疗不充分。通过适当管理高血压，可以挽救大量中风患者。
