Département de Médecine Générale, Université de Lorraine, Nancy, France.
Université de Lorraine, INSERM, Centre d'Investigation Clinique Plurithématique, UMR, and CHRU de Nancy, Nancy, France.
Fam Pract. 2019 May 23;36(3):276-283. doi: 10.1093/fampra/cmy075.
Undiagnosed arterial hypertension is frequent. Whether it is associated with gender and the absence of cardiovascular-disease warning signs is unknown. Knowledge of the features of undiagnosed-hypertension subjects may help their identification in primary care.
To examine whether gender, alcohol consumption, smoking status, health status, cardiovascular diseases/diabetes, familial hypertension history, anti-cholesterol treatment, GP-consultation frequency, body mass index (BMI), waist circumference and metabolic measurements were associated with having undiagnosed hypertension among hypertensive subjects.
This population-based study included 281 hypertensive adults (aged 50-76 years): 222 subjects with diagnosed and treated-hypertension and 59 undiagnosed-hypertension subjects (no hypertension history, office and 24-h ambulatory blood pressures ≥140/90 and ≥130/80 mmHg, respectively). Subjects' characteristics, clinical and biological measurements, health problems and blood pressures were collected. Data were analyzed using adjusted odds ratios (OR) computed with multivariable logistic regression models.
Undiagnosed-hypertension represented 21% of hypertensive subjects. Multivariable logistic regression modeling showed that five risk factors were associated with undiagnosed-hypertension among hypertensive subjects: male gender (OR = 4.61, P < 0.001), no cardiovascular diseases/diabetes (OR=8.51, P < 0.001), no familial hypertension history (OR = 3.15, P = 0.002), number of GP consultations per year (3+, 1-2, and 0; OR = 3.18 per 1-category increase, P < 0.001), and lower waist circumference (OR = 1.05 per 1-cm decrease, P = 0.002). Living alone, alcohol consumption, health status, anti-cholesterol treatment, BMI, and blood glucose were also significant factors (P < 0.05) in bivariate analysis.
Undiagnosed-hypertension subjects exhibit specific features associated with their hypertension awareness. These findings help understand undiagnosed-hypertension risk patterns and enable better identification of affected subjects for lifestyle management and care.
未确诊的动脉高血压很常见。其是否与性别以及是否存在心血管疾病警告信号有关尚不清楚。了解未确诊高血压患者的特征可能有助于在初级保健中识别他们。
检查性别、饮酒、吸烟状况、健康状况、心血管疾病/糖尿病、家族性高血压病史、胆固醇治疗、全科医生就诊频率、体重指数（BMI）、腰围和代谢测量值是否与高血压患者中的未确诊高血压有关。
本基于人群的研究纳入了 281 名高血压成年人（年龄 50-76 岁）：222 名患有确诊和治疗的高血压患者和 59 名未确诊的高血压患者（无高血压病史，诊室和 24 小时动态血压分别≥140/90 和≥130/80mmHg）。收集了受试者的特征、临床和生物学测量值、健康问题和血压数据。使用多变量逻辑回归模型计算调整后的优势比（OR）进行数据分析。
未确诊的高血压占高血压患者的 21%。多变量逻辑回归模型显示，五个危险因素与高血压患者中的未确诊高血压有关：男性（OR=4.61，P<0.001）、无心血管疾病/糖尿病（OR=8.51，P<0.001）、无家族性高血压病史（OR=3.15，P=0.002）、每年全科医生就诊次数（3+、1-2 和 0；每增加 1 类，OR 增加 3.18，P<0.001）和较低的腰围（OR=1.05 每减少 1 厘米，P=0.002）。独居、饮酒、健康状况、胆固醇治疗、BMI 和血糖在单变量分析中也是显著因素（P<0.05）。
未确诊的高血压患者表现出与他们对高血压的认识相关的特定特征。这些发现有助于了解未确诊高血压的风险模式，并能够更好地识别受影响的患者，以便进行生活方式管理和护理。
