中国高血压现状：2012-2015 年中国高血压调查结果。

Status of Hypertension in China: Results From the China Hypertension Survey, 2012-2015.

机构信息

Division of Prevention and Community Health, National Center for Cardiovascular Disease (Z.W., Z.C., L.Z., X.W., L.S., Y.T., Y.D., C.Z., J.W., M.Z.)

Division of Prevention and Community Health, National Center for Cardiovascular Disease (Z.W., Z.C., L.Z., X.W., L.S., Y.T., Y.D., C.Z., J.W., M.Z.).

出版信息

Circulation. 2018 May 29;137(22):2344-2356. doi: 10.1161/CIRCULATIONAHA.117.032380. Epub 2018 Feb 15.

DOI:10.1161/CIRCULATIONAHA.117.032380

PMID:29449338

Abstract

BACKGROUND

Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.

METHODS

A stratified multistage random sampling method was used to obtain a nationally representative sample of 451 755 residents ≥18 years of age from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mm Hg/or diastolic BP (DBP) ≥90 mm Hg or use of antihypertensive medication within 2 weeks. Pre-HTN was defined as SBP 120 to 139 mm Hg and DBP 80 to 89 mm Hg without antihypertensive medication. HTN control was defined as SBP <140 mm Hg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP ≥130 or DBP ≥80 mm Hg) and control rate (SBP <130 and DBP <80 mm Hg) of HTN were also estimated according to the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline.

RESULTS

Overall, 23.2% (≈244.5 million) of the Chinese adult population ≥18 years of age had HTN, and another 41.3% (≈435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% versus 23.1%, =0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy, and 31.7% of treated hypertensive patients used ≥2 medications. The prevalence of HTN based on the 2017 American College of Cardiology/American Heart Association guideline was twice as high as that based on 2010 Chinese guideline (46.4%), whereas the control rate fell to 3.0%.

CONCLUSIONS

In China, there is a high prevalence of HTN and pre-HTN, and awareness, treatment, and control of HTN were low. Management of medical therapy for HTN needs to improve.

摘要

背景

尽管包括中国在内的发展中国家高血压（HTN）的患病率持续上升，但最近的数据仍有所欠缺。2012 年 10 月至 2015 年 12 月期间进行了一项全国性调查，以评估中国的 HTN 患病率。

方法

采用分层多阶段随机抽样方法，从中国大陆 31 个省的≥18 岁居民中抽取了具有全国代表性的 451755 名居民作为样本。由经过培训的工作人员使用经过验证的示波血压计在休息 5 分钟后测量血压（BP）。高血压定义为收缩压（SBP）≥140mmHg/或舒张压（DBP）≥90mmHg，或在 2 周内使用降压药物。高血压前期定义为 SBP 为 120-139mmHg，DBP 为 80-89mmHg，且未服用降压药物。高血压控制定义为 SBP<140mmHg 和 DBP<90mmHg。此外，还根据 2017 年美国心脏病学会/美国心脏协会高血压指南，估计了高血压（SBP≥130 或 DBP≥80mmHg）的患病率和高血压控制率（SBP<130mmHg 和 DBP<80mmHg）。

结果

总体而言，根据中国指南，中国≥18 岁的成年人口中有 23.2%（约 2.445 亿人）患有高血压，另有 41.3%（约 4.353 亿人）患有高血压前期。城乡居民高血压患病率无显著差异（23.4%比 23.1%，=0.819）。在高血压患者中，46.9%知晓自己的病情，40.7%服用规定的降压药物，15.3%的高血压患者血压得到控制。钙通道阻滞剂是最常用的降压药物（46.5%）单药治疗，31.7%的高血压治疗患者使用≥2 种药物。根据 2017 年美国心脏病学会/美国心脏协会指南，高血压的患病率是根据 2010 年中国指南的两倍（46.4%），而控制率则降至 3.0%。