Health Analysis Division, Statistics Canada, Ottawa, Ontario.
Division of General Internal Medicine, University of Alberta, University of Alberta Chair in Cardiovascular Outcomes Research.
Health Rep. 2018 Jun 20;29(6):3-10.
In Canada, hypertension control is significantly less likely in older women taking antihypertensive medication than in older men. This study examines factors that may explain some of the differences in hypertension control between women and men.
The analysis is based on data collected for 2,111 adults aged 60 to 79 who were treated for hypertension in the first four cycles of the Canadian Health Measures Survey. Hypertension, treatment and control were estimated based on measured systolic and diastolic blood pressure and on the Drug Identification Numbers of antihypertensive medications. Risk factors included health behaviours, comorbidities and a family history of hypertension. Sex-specific logistic regression models examined associations between risk factors and hypertension control.
The systolic blood pressure of women taking antihypertensive medication was higher than that of men, regardless of hypertension control. For women, older age and diabetes were significantly associated with poorer hypertension control, while older age, ethnicity, diabetes, no cardiovascular disease, and nonsteroidal anti-inflammatory drug use were significant for men.
Based on current blood pressure targets, women and men aged 60 to 79 taking antihypertensive medication in Canada continue to differ in control and factors associated with control. Further research to better understand the underlying cause of these associations may help reduce disparities in hypertension control rates between women and men in Canada.
在加拿大,服用抗高血压药物的老年女性的高血压控制情况明显不如老年男性。本研究旨在探讨可能导致女性和男性高血压控制差异的一些因素。
本分析基于加拿大健康测量调查前四个周期中 2111 名年龄在 60 至 79 岁之间接受高血压治疗的成年人的数据。高血压、治疗和控制情况是根据测量的收缩压和舒张压以及抗高血压药物的药物识别号码来估计的。危险因素包括健康行为、合并症和高血压家族史。性别特异性逻辑回归模型检查了危险因素与高血压控制之间的关联。
无论高血压控制情况如何,服用抗高血压药物的女性的收缩压均高于男性。对于女性,年龄较大和糖尿病与较差的高血压控制显著相关,而对于男性,年龄较大、种族、糖尿病、无心血管疾病和非甾体抗炎药的使用与较差的高血压控制显著相关。
根据目前的血压目标,在加拿大,服用抗高血压药物的 60 至 79 岁的女性和男性在控制方面仍存在差异,且控制情况与相关因素也存在差异。进一步的研究以更好地了解这些关联的根本原因,可能有助于减少加拿大女性和男性高血压控制率的差异。