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育龄女性中的高血压:2017年美国心脏病学会/美国心脏协会高血压指南的影响

Hypertension among women of reproductive age: Impact of 2017 American College of Cardiology/American Heart Association high blood pressure guideline.

作者信息

Chen Han-Yang, Chauhan Suneet P

机构信息

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.

出版信息

Int J Cardiol Hypertens. 2019 May 7;1:100007. doi: 10.1016/j.ijchy.2019.100007. eCollection 2019 May.

Abstract

OBJECTIVE

To estimate the prevalence of hypertension and antihypertensive medication recommended among U.S. reproductive-aged women according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline as compared with the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) guideline and to identify factors associated with newly classified hypertensive women.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey 2005-2014. Hypertension was defined using blood pressure measurements and/or self-reported antihypertensive medication use. Multivariable Poisson regression models with robust error variance were conducted.

RESULTS

Among 4,575 (weighted n ​= ​40,194,602) non-pregnant women aged 20-44 years, the prevalence of hypertension was 16.5% using the 2017 guideline, and 7.8% based on the JNC7 guideline. Following the 2017 guideline, 8.6% would be recommended for antihypertensive medication, similar to 8.5% according to JNC7 guideline. Following the 2017 guideline, women with older age (35-44 years), obesity, and diabetes were more likely, while Hispanic women were less likely, to be newly classified as hypertensive.

CONCLUSION

Among reproductive-aged women, compared to JNC7 guidelines, the prevalence of hypertension increased by 112% following the 2017 guideline, but the percentage of women recommended for antihypertensive medication was similar.

摘要

目的

根据2017年美国心脏病学会/美国心脏协会(ACC/AHA)指南,评估美国育龄妇女中高血压的患病率以及推荐使用的降压药物,并与美国预防、检测、评估与治疗高血压联合委员会第七次报告(JNC7)指南进行比较,同时确定新分类的高血压女性的相关因素。

方法

我们分析了2005 - 2014年美国国家健康与营养检查调查的数据。高血压通过血压测量和/或自我报告的降压药物使用情况来定义。采用具有稳健误差方差的多变量泊松回归模型进行分析。

结果

在4575名(加权n = 40194602)年龄在20 - 44岁的非孕妇中,按照2017年指南,高血压患病率为16.5%,而根据JNC7指南为7.8%。按照2017年指南,8.6%的人会被推荐使用降压药物,这与JNC7指南的8.5%相似。按照2017年指南,年龄较大(35 - 44岁)、肥胖和患有糖尿病的女性更有可能被新分类为高血压患者,而西班牙裔女性则可能性较小。

结论

在育龄妇女中,与JNC7指南相比,按照2017年指南,高血压患病率增加了112%,但被推荐使用降压药物的女性比例相似。

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