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中国西南地区年轻人患高血压的风险增加:2017 年 ACC/AHA 高血压指南的影响。

Increased Risk of Hypertension in Young Adults in Southwest China: Impact of the 2017 ACC/AHA High Blood Pressure Guideline.

机构信息

Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.

Public Health School of Chongqing Medical University Chongqing, Chongqing, China.

出版信息

Curr Hypertens Rep. 2019 Feb 28;21(3):21. doi: 10.1007/s11906-019-0926-y.

Abstract

PURPOSE OF REVIEW

To examine the impact of the new 2017 ACC/AHA hypertension guideline on the prevalence of hypertension, its constituent ratio, and their associated factors in southwest China.

RECENT FINDINGS

A total of 14,220 permanent residents ≥ 18 years were enrolled in this survey. According to the 2017 ACC/AHA hypertension guideline, the hypertension prevalence was substantially increased (46.9% vs. 24.5%); consistent across different age and gender groups, while the hypertension awareness (23.8% vs. 45.6%); treatment (18.6% vs. 35.5%); control (2.3% vs. 11.2%); and control among treatment (9.6% vs. 24.0%) patients were decreased in southwest of China. In our cohort, 31.1% participants were newly diagnosed as hypertension. Young adults accounted considerable proportion in this newly diagnosed hypertension population. The proportion of young hypertensive individuals substantially increased, whereas those of the older hypertensive subjects decreased. Among the hypertensive subjects aged ≥ 65 years undergoing treatment, 90% of the elderly subjects were not eligible for hypertension control and 32.5% have systolic blood pressure control at 130-149 mmHg, and thus need to intensify antihypertensive treatment according to 2017 ACC/AHA hypertension guideline. Smoking, drinking, body fat percentage, and body mass index were considered the factors associated with hypertension according to the Chinese hypertension guideline but not in the 2017 ACC/AHA hypertension guideline. The adoption of the 2017 ACC/AHA hypertension guideline will substantially increase hypertension prevalence in southwest of China. The new definition of hypertension implies that more young adults will likely suffer from high cardiovascular risks, while additional one third of elder hypertensive subjects will likely need intensified antihypertension treatments.

摘要

目的

研究 2017 年 ACC/AHA 高血压指南对中国西南地区高血压患病率、构成比及其相关因素的影响。

最近的发现

本调查共纳入 14220 名≥18 岁的常住居民。根据 2017 年 ACC/AHA 高血压指南,高血压患病率显著增加(46.9%比 24.5%);在不同年龄和性别组中一致,而高血压知晓率(23.8%比 45.6%)、治疗率(18.6%比 35.5%)、控制率(2.3%比 11.2%)和治疗控制率(9.6%比 24.0%)均降低。在本队列中,31.1%的参与者被新诊断为高血压。年轻成年人在这一新诊断的高血压人群中占有相当大的比例。年轻高血压患者的比例显著增加,而老年高血压患者的比例下降。在接受治疗的≥65 岁高血压患者中,90%的老年患者不符合高血压控制标准,32.5%的患者收缩压控制在 130-149mmHg,因此需要根据 2017 年 ACC/AHA 高血压指南加强降压治疗。根据中国高血压指南,吸烟、饮酒、体脂百分比和体重指数被认为是与高血压相关的因素,但 2017 年 ACC/AHA 高血压指南中没有提到这些因素。采用 2017 年 ACC/AHA 高血压指南将显著增加中国西南地区高血压的患病率。高血压的新定义意味着更多的年轻人可能会面临更高的心血管风险,而另外三分之一的老年高血压患者可能需要强化降压治疗。

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