Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois.
Special Olympics Inc., Washington, District of Columbia.
Am J Prev Med. 2020 May;58(5):630-637. doi: 10.1016/j.amepre.2019.12.011. Epub 2020 Feb 12.
Individuals with intellectual disability have a high prevalence of obesity and low physical activity levels, which are risk factors for hypertension. This study estimated the prevalence of hypertension in a global data set of adults with intellectual disability participating in Special Olympics and investigated the role of physical activity and obesity in hypertension risk.
A total of 33,122 individuals aged ≥18 years with intellectual disability who participated in Special Olympic events from 2014 to 2018 had their brachial blood pressure, BMI, and self-reported physical activity assessed. Hypertension was classified using 2017 American College of Cardiology/American Heart Association guidelines (systolic blood pressure≥130 mmHg and diastolic blood pressure≥80 mmHg). Data were analyzed in 2019.
Participants were aged 31 (SD=11) years, 64% male, and had a resting blood pressure of 121 (SD=16)/76 (SD=12) mmHg. The population was 48% (95% CI=47.5%, 48.6%) hypertensive. Male participants had a higher prevalence of hypertension (50.7%, 95% CI=50.1%, 51.4%) than female participants (43.1%, 95% CI=42.2%, 44.0%), with prevalence increasing with age. Odds of hypertension increased when performing no or insufficient physical activity and with increasing obesity (p<0.01), tripling (OR=3.06, 3.66) for all individuals who performed no physical activity except for those of normal weight (OR=1.72), and doubling (OR=2.13-3.87) for individuals who were obese or morbidly obese across all physical activity levels.
This study is the first to determine population-based prevalence rates of hypertension in individuals with intellectual disability. It highlights the similarity in prevalence to the general population. The results emphasize the importance of population-wide screening, increasing physical activity, and reducing obesity in decreasing cardiovascular risk in this population.
智力障碍个体中肥胖和身体活动水平低的患病率较高,而这些都是高血压的危险因素。本研究评估了参加特奥会的全球智力障碍成年人群体中高血压的患病率,并探讨了身体活动和肥胖在高血压风险中的作用。
共有 33122 名年龄≥18 岁的智力障碍个体参加了 2014 年至 2018 年的特奥会,评估了他们的肱动脉血压、BMI 和自我报告的身体活动情况。高血压采用 2017 年美国心脏病学会/美国心脏协会指南进行分类(收缩压≥130mmHg 和舒张压≥80mmHg)。数据分析于 2019 年进行。
参与者的年龄为 31 岁(标准差=11 岁),64%为男性,静息血压为 121(标准差=16)/76(标准差=12)mmHg。该人群中有 48%(95%置信区间=47.5%,48.6%)患有高血压。男性参与者的高血压患病率(50.7%,95%置信区间=50.1%,51.4%)高于女性参与者(43.1%,95%置信区间=42.2%,44.0%),且患病率随年龄增长而增加。不进行或进行不足的身体活动以及肥胖程度增加时,高血压的患病风险增加(p<0.01),对于除正常体重者之外的所有不进行身体活动的个体,患病风险增加三倍(比值比=3.06,3.66),对于所有身体活动水平下肥胖或病态肥胖的个体,患病风险增加两倍(比值比=2.13-3.87)。
本研究首次确定了智力障碍个体中基于人群的高血压患病率。它突出了与一般人群相似的患病率。结果强调了在该人群中进行广泛的人群筛查、增加身体活动和减少肥胖以降低心血管风险的重要性。