Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
Graduate School of Public Health, Korea University, Seoul, Korea.
PLoS One. 2020 Mar 17;15(3):e0230538. doi: 10.1371/journal.pone.0230538. eCollection 2020.
Although the high disease burden that results from cardiovascular complications of hypertension, factors related to the progression to hypertension in the normotensive population are not actively reported. The purpose of this study was to estimate the rate of the progression to hypertension and to reveal the associated risk factors.
The study included normotensive participants from the National Health Insurance Service-National Health Screening Cohort, and contained a 10% sample of all adults who received a national health screening test in either 2002 or 2003. At the end of the study in 2015, the patients were divided into two groups based on whether or not they progressed to hypertension. Cox proportional hazard modeling was performed to identify risk factors for progression. Subgroup analysis using logistic regression was employed to reveal factors influencing the different natural history of the progression.
Among the 75,335 included participants, the progression rate to hypertension was 66.39% (50,013), with an adjusted incidence rate of 8.62 per 100 person-year in the aged 40-64 group and 12.68 in the aged 65 or above group. Age, BMI, hemoglobin, and family history of hypertension and other diseases were related to the progression. Among the progression group, 78.21% (39,116) participants skipped a pre-hypertensive status; this group consisted of older females with lower pulse pressure and more alcohol consumption compared to people who had pre-hypertensive status before the progression.
Substantial risk factors for the progression to hypertension should be carefully managed even in normotensive participants who receive health screening tests.
尽管高血压引起的心血管并发症带来了很高的疾病负担，但与正常血压人群中高血压进展相关的因素并未得到积极报道。本研究旨在评估正常血压人群中高血压进展的发生率，并揭示相关的危险因素。
本研究纳入了来自国民健康保险服务-国民健康筛查队列的正常血压参与者，包含了 2002 年或 2003 年接受国家健康筛查测试的所有成年人的 10%样本。在 2015 年研究结束时，根据患者是否进展为高血压将其分为两组。采用 Cox 比例风险模型识别进展的危险因素。采用逻辑回归进行亚组分析，揭示影响不同进展自然史的因素。
在纳入的 75335 名参与者中，高血压进展率为 66.39%（50013 人），年龄在 40-64 岁组的调整发病率为每 100 人年 8.62 例，年龄在 65 岁及以上组为 12.68 例。年龄、BMI、血红蛋白、高血压和其他疾病家族史与进展有关。在进展组中，78.21%（39116 人）的参与者跳过了高血压前期状态；与进展前有高血压前期状态的人相比，该组由年龄较大的女性组成，其脉压较低，饮酒量较多。
即使在接受健康筛查测试的正常血压参与者中，也应谨慎管理高血压进展的重要危险因素。
