King's College, London, UK.
J Hypertens. 2019 Dec;37(12):2470-2480. doi: 10.1097/HJH.0000000000002192.
To estimate percentages of patients with undiagnosed hypertension, diagnosed untreated hypertension and diagnosed, treated and uncontrolled hypertension and to identify sociodemographic factors for diagnosed, uncontrolled hypertension and not having a blood pressure (BP) reading recorded.
Data from 320 094 patients aged 18 to less than 80 years from general practices in inner London was analysed using both last recorded BP (blood pressure) and mean BP. Logistic regression models identified factors associated with uncontrolled hypertension and no recorded BP.
Twenty-nine thousand, seven hundred and nineteen (9.3%) patients had a recorded diagnosis of hypertension. On the basis of analysis of the last BP value, 14.2% (n = 4207) were untreated and 46.3% (n = 13 749) had uncontrolled hypertension; 10.0% (n = 28 274) without a prior hypertension diagnosis had undiagnosed hypertension. Corresponding values based on mean BP analysis were 8.9% (n = 2367) untreated, 51.5% (n = 13 734) uncontrolled; 4.1% (n = 11 446) undiagnosed. 17.5% (n = 55 960) had no recorded BP value.Black ethnicity was a predictor of uncontrolled hypertension: compared with the White British population, the adjusted odds ratio (AOR) for the Black African population was 1.39 (95% CI: 1.25-1.53) and for the Black Caribbean was 1.31 (95% CI: 1.19-1.45). The White Other group were most likely to have no record of BP measurement (AOR: 1.52; 95% CI: 1.47-1.57); conversely, unrecorded BP was less likely in the Black African (AOR: 0.79; CI: 0.74-0.83) and Black Caribbean (AOR: 0.71; CI: 0.66-0.76) groups, relative to the White British population.
In an inner-city, multiethnic population, the 'rule of halves' still broadly applies to the diagnosis and control of hypertension, although only a small proportion were untreated.
估计未确诊高血压、确诊未经治疗的高血压以及确诊、治疗但血压控制不良的高血压患者比例，并确定与确诊但血压控制不良以及未记录血压读数相关的社会人口学因素。
利用来自伦敦市内各综合医疗机构的 320094 名年龄在 18 岁以下至 80 岁以下的患者的数据，采用最后一次记录的血压（血压）和平均血压进行分析。逻辑回归模型确定了与血压控制不良和未记录血压相关的因素。
29719 名（9.3%）患者有记录的高血压诊断。根据最后一次血压值分析，14.2%（n=4207）未经治疗，46.3%（n=13749）血压控制不良；10.0%（n=28274）无高血压既往诊断的患者患有未确诊的高血压。基于平均血压分析的相应值分别为 8.9%（n=2367）未经治疗，51.5%（n=13734）血压控制不良；4.1%（n=11446）未确诊。有 17.5%（n=55960）未记录血压值。黑种人是血压控制不良的预测因素：与白种英国人相比，黑非洲人口的调整后比值比（AOR）为 1.39（95%CI：1.25-1.53），黑加勒比人为 1.31（95%CI：1.19-1.45）。白种其他人最有可能没有记录血压测量值（AOR：1.52；95%CI：1.47-1.57）；相反，黑非洲（AOR：0.79；CI：0.74-0.83）和黑加勒比（AOR：0.71；CI：0.66-0.76）人群的未记录血压值较白种英国人低。
在一个城市中心、多种族人群中，“对半法则”仍然广泛适用于高血压的诊断和控制，尽管未经治疗的患者比例很小。
