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2017 ACC/AHA 指南下高血压的患病率:系统评价和荟萃分析。

Prevalence of high blood pressure under 2017 ACC/AHA guidelines: a systematic review and meta-analysis.

机构信息

Zhanggong District Center for Disease Control and Prevention, Ganzhou, 341000, Jiangxi, PR China.

Shantou University Medical College, Shantou, 515000, Guangdong, PR China.

出版信息

J Hum Hypertens. 2021 Mar;35(3):193-206. doi: 10.1038/s41371-020-00454-8. Epub 2020 Dec 8.

Abstract

To understand the prevalence of high blood pressure among the general adult population under the new diagnostic criteria. PubMed and Embase databases were systematically searched. Two investigators independently performed data extraction and quality assessment, and the disagreements were resolved by consensus with a third investigator. The random-effects model was performed to pool the prevalence of high blood pressure among the population. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. The study protocol has been registered with PROSPERO, number CRD42019147330. In total, 52 articles included in the meta-analysis with a total of 54 studies. An obvious increase in the prevalence of high blood pressure was identified by the application of new diagnostic criteria. The pooled prevalence of high blood pressure among the population was 53.01% (95% confidence interval 51.13-54.88%). Subgroup analysis showed that the WHO region, national, and age could significantly influence the prevalence of hypertension (P < 0.01). Meta-regression analyses revealed that study quality and sex ratio (male, %) did not contribute to the heterogeneity of the results (P > 0.05). The sensitivity analysis showed that the results were stable. With the use of new diagnostic criteria, the prevalence of high blood pressure has shown an upward trend, especially in Europe countries. Prevention and control measures should focus more on improving cardiovascular and cerebrovascular status in Europe countries. Standard electronic blood pressure monitors were recommended for use in future studies, and at least two more readings should be taken during a visit.

摘要

为了了解新诊断标准下一般成年人群高血压的患病率。系统地检索了 PubMed 和 Embase 数据库。两名调查员独立进行数据提取和质量评估,分歧由第三名调查员协商解决。采用随机效应模型汇总人群高血压患病率。进行亚组和荟萃回归分析以探讨异质性的来源。研究方案已在 PROSPERO 中注册,编号 CRD42019147330。共有 52 篇文章纳入荟萃分析,共 54 项研究。应用新诊断标准后,高血压的患病率明显增加。人群高血压的总患病率为 53.01%(95%置信区间 51.13-54.88%)。亚组分析表明,世卫组织区域、国家和年龄可显著影响高血压的患病率(P<0.01)。荟萃回归分析显示,研究质量和性别比例(男性%)对结果的异质性没有影响(P>0.05)。敏感性分析表明结果稳定。使用新的诊断标准,高血压的患病率呈上升趋势,尤其是在欧洲国家。预防和控制措施应更侧重于改善欧洲国家的心血管和脑血管状况。建议在未来的研究中使用标准的电子血压计,并在就诊期间至少再测量两次。

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