Department of Internal Medicine 2 (Cardiology, Intensive Care Medicine), Klinikum Wels-Grieskirchen, Wels, Austria.
Board of Pharmacists, Upper Austria, Austria.
J Hum Hypertens. 2020 Apr;34(4):326-334. doi: 10.1038/s41371-019-0222-y. Epub 2019 Jul 29.
Cardiovascular mortality is the leading cause of death in Austria, with uncontrolled blood pressure (BP) as a major risk factor. Increased arterial stiffness can indicate high cardiovascular risk. In a screening project, we acquired brachial waveforms with automated oscillometric devices in 45 public pharmacies and at 2 public health events in Upper Austria. Brachial BP was measured, and aortic pulse wave velocity (aoPWV) was estimated, using age, systolic BP, and waveform characteristics, with the validated ARCSolver algorithm. Using age-specific percentiles from a previous population study, we defined healthy (HVA) and early (EVA) vascular aging. In a subgroup, 24-h ambulatory BP monitoring was performed to verify hypertension status. Overall, 10,973 individuals (age 20-94 years) participated. Mean BP was 133/83 mm Hg. In all, 38.1% of participants had elevated BPs (≥140/90 mm Hg), 57.3% out of 3980 participants with known hypertension, and 29.5% out of 6066 participants without known hypertension. In all, 1.0% of participants had aoPWV below 10th reference percentile (HVA), with a negligible proportion above 60 years. In total, 37.3% were above the 90th reference percentile (EVA), with proportions rising from one-quarter in youngest partcipants to one-half in oldest participants. In participants with EVA, BP in the pharmacy was elevated in 79.5%. We were able to motivate a high number of customers at pharmacies to participate in a screening program by combining the measurements of BP and vascular aging. However, awareness and control of arterial hypertension in Austria remains suboptimal, and the high prevalence of EVA is alarming.
心血管死亡率是奥地利的主要死因，而未得到控制的血压（BP）是一个主要的危险因素。动脉僵硬度增加可能表明心血管风险较高。在一项筛查项目中，我们在奥地利上奥地利的 45 家公共药店和 2 个公共卫生事件中使用自动振荡测量设备获取了肱动脉波形。使用年龄、收缩压和波形特征，使用经过验证的 ARCSolver 算法测量肱动脉血压（BP）并估计主动脉脉搏波速度（aoPWV）。使用之前一项人群研究的年龄特异性百分位数，我们定义了健康（HVA）和早期（EVA）血管老化。在一个亚组中，进行了 24 小时动态血压监测以验证高血压状态。总共有 10973 人（年龄 20-94 岁）参与。平均血压为 133/83mmHg。总共有 38.1%的参与者血压升高（≥140/90mmHg），3980 名已知高血压患者中有 57.3%，6066 名无已知高血压患者中有 29.5%。总共有 1.0%的参与者的 aoPWV 低于第 10 个参考百分位（HVA），60 岁以上的比例可忽略不计。总共有 37.3%的参与者高于第 90 个参考百分位（EVA），从最年轻的参与者的四分之一上升到最年长的参与者的一半。在 EVA 患者中，79.5%的患者在药店的血压升高。我们通过将血压和血管老化的测量结合起来，成功地激励了大量药店的顾客参与筛查计划。然而，奥地利的动脉高血压的知晓率和控制率仍然不理想，EVA 的高患病率令人震惊。
