Zamboni S, Ambrosio G B, Stefanini M G, Urbani V, Mazzucato L, Dal Palù C
G Ital Cardiol. 1986 Nov;16(11):922-33.
A pilot project for the control of hypertension in the Community was carried out in Italy as a part of the WHO Programme "Community Control of Hypertension". 1190 subjects identified as hypertensive (BP greater than or equal to 160 and/or 95 mmHg at two subsequent measurements, or under treatment) during the screening of a random sample of the population between 20 and 64 years in the District of Camposampiero (Padova) were enrolled in a Hypertension Register during a subsequent visit (Registration Visit: VR) carried out two months after the screening. In the following 5 years they were recalled about once a year at a Hypertension Clinic for a complete visit (VA). On both the VR and the VAs a resting electrocardiogram (ECG) was recorded and subsequently assessed according to the Minnesota Code (MC). Out of the 1190 registered hypertensive subjects, 872 (400 males and 472 females) participated in the last VA visit after 5 years, which corresponds to an overall participation rate of 69.4% in males (M) and 76.9% in females (F). Among subjects with normal and abnormal ECG at the VR, the participation rates at the last VA were, respectively, 67.9 and 71.5% in M (not significant difference); 80.0% and 70.8% in F (significant difference: P less than 0.001). Between the VR and the last VA the mean BP values of the 872 subjects investigated decreased from 162. 9/102.2 mmHg to 148. 6/90.4 mmHg in M and from 168. 7/102.2 mmHg to 155. 3/91.7 mmHg in F. The rate of abnormal ECGs increased from 44.0% to 50.3% in M and from 36.4% to 47.9% in F, involving most single items and all the classes of the MC with the exception of classes 8 and 9. The items which diminished generally had a rather low prevalence or were those indicating minor abnormalities. The apparent regression of some pathological patterns could actually be accounted for by a shift towards more severe abnormalities. The most remarkable changes occurred in codes indicating respectively left ventricular hypertrophy (3: 1 or 3: 3) and myocardial ischaemia (4: 1-3 or 5: 1-3 or 7: 1).(ABSTRACT TRUNCATED AT 400 WORDS)
作为世界卫生组织“社区高血压控制”项目的一部分，意大利开展了一项社区高血压控制试点项目。在对坎波桑皮耶罗区（帕多瓦）20至64岁人群的随机样本进行筛查期间，有1190名被确定为高血压患者（后续两次测量血压大于或等于160和/或95 mmHg，或正在接受治疗），在筛查后两个月进行的后续就诊（登记就诊：VR）时被纳入高血压登记册。在接下来的5年里，他们每年约被召回一次到高血压诊所进行全面就诊（VA）。在VR和VA就诊时均记录静息心电图（ECG），随后根据明尼苏达编码（MC）进行评估。在1190名登记的高血压患者中，872名（400名男性和472名女性）在5年后参加了最后一次VA就诊，男性的总体参与率为69.4%，女性为76.9%。在VR时心电图正常和异常的患者中，最后一次VA就诊的参与率在男性中分别为67.9%和71.5%（无显著差异）；在女性中分别为80.0%和70.8%（显著差异：P<0.001）。在VR和最后一次VA之间，872名被调查患者的平均血压值在男性中从162.9/102.2 mmHg降至148.6/90.4 mmHg，在女性中从168.7/102.2 mmHg降至155.3/91.7 mmHg。男性中异常心电图的发生率从44.0%升至50.3%，女性从36.4%升至47.9%，涉及大多数单项及MC的所有类别，但8类和9类除外。发生率降低的项目通常患病率较低或表明为轻微异常。一些病理模式的明显消退实际上可能是由于向更严重异常的转变。最显著的变化分别发生在表明左心室肥厚（3:1或3:3）和心肌缺血（4:1 - 3或5:1 - 3或7:1）的编码中。（摘要截选至400字）
