2017 年美国心脏病学会/美国心脏协会高血压指南对中国成年人的潜在影响及应对策略。
Potential impacts of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline on Chinese adults and how to address them.
机构信息
Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
Department of Clinical Epidemiology, Department of Library, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
出版信息
BMC Cardiovasc Disord. 2020 May 19;20(1):237. doi: 10.1186/s12872-020-01523-z.
BACKGROUND
The current analysis was performed to estimate the percentage and number of Chinese adults with hypertension and the percentage and number of Chinese adults recommended to receive pharmacological antihypertensive treatment according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline compared with the same parameters according to the 2010 Chinese guideline.
METHODS
We used 2011 data from the China Health and Nutrition Survey (CHNS). A total of 12,499 Chinese adults aged ≥18 years with complete blood pressure (BP) values were selected for the present analysis.
RESULTS
The crude prevalence rates (95% CI) of hypertension according to the definitions from the 2017 ACC/AHA guideline and the 2010 Chinese guideline were 58.0% (57.2 to 58.9%) and 25.4% (24.7 to 26.2%), respectively. Moreover, the percentage of the participants recommended to take antihypertensive medications were 31.5 and 28.8%, respectively. Among adults who took antihypertensive medications, 88.8% had above-goal BP levels compared to 53.3%. Overall, 613.3 million Chinese adults (aged ≥18 years) met the criteria for hypertension according to the 2017 ACC/AHA guideline, and 267.7 million met the criteria according to 2010 Chinese guideline. An additional 28.4 million (2.7%) Chinese adults were recommended to take antihypertensive medication.
CONCLUSIONS
The present analysis revealed that the 2017 ACC/AHA hypertension guideline will result in a substantial increase in the percentage and number of Chinese adults defined as having hypertension and a small increase in the percentage of adults who are recommended to take antihypertensive medications compared to the same parameters based on the 2010 Chinese guideline. More intensive management and antihypertensive medications use are suggested to improve the control rate of hypertension among Chinese adults.
背景
本分析旨在根据 2017 年美国心脏病学会/美国心脏协会（ACC/AHA）指南估计中国高血压成人的百分比和人数，以及根据 2010 年中国指南建议接受药物降压治疗的百分比和人数。
方法
我们使用了 2011 年中国健康与营养调查（CHNS）的数据。本分析共纳入了 12499 名年龄≥18 岁、有完整血压值的中国成年人。
结果
根据 2017 年 ACC/AHA 指南和 2010 年中国指南的定义，高血压的粗患病率（95%CI）分别为 58.0%（57.2%至 58.9%）和 25.4%（24.7%至 26.2%）。此外，建议服用降压药物的患者比例分别为 31.5%和 28.8%。在服用降压药物的成年人中，有 88.8%的人血压水平仍高于目标值，而这一比例在中国指南中为 53.3%。总体而言，根据 2017 年 ACC/AHA 指南，有 6.133 亿中国成年人（年龄≥18 岁）符合高血压标准，而根据 2010 年中国指南，有 6.133 亿中国成年人符合高血压标准。另有 2840 万（2.7%）中国成年人被建议服用降压药物。
结论
本分析显示，与 2010 年中国指南相比，根据 2017 年 ACC/AHA 高血压指南，中国被定义为患有高血压的成年人的百分比和人数将大幅增加，建议服用降压药物的成年人的百分比将略有增加。建议加强管理并增加降压药物的使用，以提高中国成年人高血压的控制率。
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