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潜伏在众目睽睽之下:纽约市出租车/网约车司机的高血压认知和治疗情况。

Lurking in plain sight: Hypertension awareness and treatment among New York City taxi/for-hire vehicle drivers.

机构信息

Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA.

出版信息

J Clin Hypertens (Greenwich). 2020 Jun;22(6):962-969. doi: 10.1111/jch.13869. Epub 2020 May 21.

Abstract

Hypertension is a risk factor for cardiovascular disease, which is the leading cause of death in the United States. Taxi and for-hire vehicle (FHV) drivers, a largely male, immigrant and medically underserved population, are at increased risk of cardiovascular disease, in part due to the nature of their work. This study examined demographic and lifestyle predictors of hypertension diagnosis awareness, objectively measured blood pressure (hypertensive-range vs non-hypertensive-range readings), medication use, and hypertension control. A cross-sectional assessment was conducted with 983 male taxi/FHV drivers who attended health fairs in New York City from 2010 to 2017. Twenty-three percent self-reported a hypertension history and 46% had hypertensive-range BP readings. Approximately, half the drivers lacked health insurance (47%) and a usual care source (46%). Thirty percent did not self-report hypertension and had hypertensive-range BP readings. Medication use was reported by 69% of hypertension-aware drivers, and being older and having health care access (insurance, a usual care source, and seeing a doctor in the past year) was significantly associated with medication use. Hypertension-unaware drivers with hypertensive-range BP readings were less likely to have a usual care source. Over 60% of drivers who were hypertension-aware and on medication had hypertensive-range readings. There is a need for community-based and workplace driver and provider interventions to address BP awareness and management and to provide health care navigation for vulnerable populations such as taxi/FHV vehicle drivers.

摘要

高血压是心血管疾病的一个风险因素,而心血管疾病是美国的主要死因。出租车和网约车司机(主要为男性、移民和医疗服务不足的人群)患心血管疾病的风险增加,部分原因是他们工作的性质。本研究旨在调查高血压诊断意识、客观测量血压(高血压范围与非高血压范围读数)、药物使用和高血压控制的人口统计学和生活方式预测因素。2010 年至 2017 年,在纽约市参加健康博览会的 983 名男性出租车/网约车司机中进行了横断面评估。23%的司机自述有高血压病史,46%的司机血压读数处于高血压范围。大约一半的司机没有医疗保险(47%)和常规医疗服务来源(46%)。30%的司机没有报告高血压,但血压读数处于高血压范围。报告使用药物的高血压意识司机占 69%,而年龄较大、获得医疗保健(保险、常规医疗服务来源和过去一年看医生)与药物使用显著相关。血压处于高血压范围但没有报告高血压的司机不太可能有常规医疗服务来源。超过 60%的高血压意识和正在服用药物的司机血压读数仍处于高血压范围。需要在社区和工作场所对司机和医疗服务提供者进行干预,以提高对血压的认识和管理,并为出租车/网约车司机等弱势群体提供医疗保健导航。

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