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2017年美国心脏病学会/美国心脏协会高血压指南对中国人群潜在的流行病学影响:辽宁省农村地区的一项横断面研究。

Potential epidemiological impact of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline on the Chinese population: a cross-sectional study in rural areas of Liaoning Province.

作者信息

Dong Yuanyuan, Sun Zhaoqing, Li Zhao, Guo Xiaofan, Sun Guozhe, Xie Yanxia, Zheng Jia, Dai Yue, Wang Yali, Guo Rongrong, Zheng Liqiang, Sun Yingxian

机构信息

Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.

出版信息

BMJ Open. 2020 Sep 22;10(9):e035900. doi: 10.1136/bmjopen-2019-035900.

Abstract

OBJECTIVES

The present study estimated the percentage of rural Chinese adults with hypertension and recommended pharmacological antihypertensive treatment according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline compared with the 2010 Chinese Guideline for the Management of Hypertension.

DESIGN

Cross-sectional study.

SETTING

Three counties in rural areas of northeastern China.

PARTICIPANTS

A total of 11 747 eligible individuals aged ≥35 years from rural areas of northeastern China were selected for the present analysis.

MAIN OUTCOME MEASURES

The percentage of rural Chinese adults with hypertension and recommended pharmacological antihypertensive treatment according to the 2017 ACC/AHA guideline and the 2010 Chinese Guideline for the Management of Hypertension, and the proportion of rural Chinese adults taking antihypertensive medication with blood pressure (BP) above the 2017 ACC/AHA guideline and the 2010 Chinese guideline treatment goal.

RESULTS

The mean age of the study population was 53.9±10.8 years and 53.7% of the participants were women. According to the 2017 ACC/AHA guideline and the 2010 Chinese guideline, the crude prevalence of hypertension was 72.2% and 49.8%, respectively, and the percentage of recommended antihypertensive medications for rural Chinese adults was 56.4% and 51.4%, respectively. Among these rural Chinese adults taking antihypertensive medications, 96.7% had above goal BP according to the 2017 ACC/AHA guideline compared with 86.1% with above goal BP according to the 2010 Chinese guideline.

CONCLUSION

The present analysis demonstrated that compared with the 2010 Chinese guideline, the 2017 ACC/AHA hypertension guideline will result in a substantial increase in the percentage of rural Chinese adults defined as having hypertension and a small increase in the percentage of adults who are recommended antihypertensive medications. More intensive management is suggested to improve the control rate of hypertension among rural Chinese adults.

摘要

目的

本研究估计了中国农村成年人高血压的患病率,并根据2017年美国心脏病学会/美国心脏协会(ACC/AHA)指南与2010年《中国高血压防治指南》比较,推荐了药物降压治疗方案。

设计

横断面研究。

地点

中国东北农村地区的三个县。

参与者

本分析共纳入了来自中国东北农村地区的11747名年龄≥35岁的符合条件的个体。

主要观察指标

根据2017年ACC/AHA指南和2010年《中国高血压防治指南》,中国农村成年人高血压的患病率及推荐药物降压治疗的比例,以及血压高于2017年ACC/AHA指南和2010年中国指南治疗目标的服用降压药物的中国农村成年人的比例。

结果

研究人群的平均年龄为53.9±10.8岁,53.7%的参与者为女性。根据2017年ACC/AHA指南和2010年中国指南,高血压的粗患病率分别为72.2%和49.8%,中国农村成年人推荐使用降压药物的比例分别为56.4%和51.4%。在这些服用降压药物的中国农村成年人中,根据2017年ACC/AHA指南,96.7%的人的血压高于目标值,而根据2010年中国指南,这一比例为86.1%。

结论

本分析表明,与2010年中国指南相比,2017年ACC/AHA高血压指南将使被定义为患有高血压的中国农村成年人的比例大幅增加,而推荐使用降压药物的成年人比例略有增加。建议采取更强化的管理措施以提高中国农村成年人高血压的控制率。

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