Shaper A G, Ashby D, Pocock S J
Department of Clinical Epidemiology and General Practice, Royal Free Hospital School of Medicine, London, UK.
J Hypertens. 1988 May;6(5):367-74.
Blood pressure measurements in 7735 middle-aged men from general practices in 24 towns in England, Wales and Scotland provide information on the prevalence of hypertension and its management in Great Britain. Despite a substantial correlation (r = 0.70) between systolic and diastolic blood pressures, individuals can show considerable discrepancies between these two measurements; they are not interchangeable. This observation has important implications for the choice of criteria used to define hypertension. However defined, the prevalence of hypertension increases markedly with age, increasing body mass index and with heavy alcohol consumption. It is not related to smoking and only to a small extent to social class. Diastolic hypertension (greater than or equal to 90 mmHg) was present in 26% and systolic hypertension (greater than or equal to 160 mmHg) in 22% of these men. In both systolic and diastolic hypertension, only one quarter of affected men could recall having been diagnosed as hypertensive by a doctor, and only one third of these were on regular antihypertensive treatment. There is a threefold variation in the prevalence of measured hypertension in the 24 towns with a trend towards higher rates in Northern England and Scotland. No relationship was seen between the prevalence rates of measured hypertension in the towns and the rates of doctor diagnosis of hypertension. Cardiovascular mortality rates in the towns were correlated with the measured prevalence rates for systolic and diastolic hypertension (r = 0.70 and r = 0.57, respectively). The geographic variations in blood pressure and hypertension in Great Britain provide a major opportunity for research into the causes of 'essential' hypertension.
对来自英格兰、威尔士和苏格兰24个城镇普通诊所的7735名中年男性进行的血压测量，提供了有关英国高血压患病率及其管理情况的信息。尽管收缩压和舒张压之间存在显著相关性（r = 0.70），但个体的这两种测量值之间可能存在相当大的差异；它们不可互换。这一观察结果对用于定义高血压的标准选择具有重要意义。无论如何定义，高血压患病率都会随着年龄、体重指数的增加以及大量饮酒而显著上升。它与吸烟无关，仅在很小程度上与社会阶层有关。在这些男性中，26%患有舒张期高血压（大于或等于90 mmHg），22%患有收缩期高血压（大于或等于160 mmHg）。在收缩期和舒张期高血压患者中，只有四分之一的患者记得曾被医生诊断为高血压，而这些患者中只有三分之一正在接受常规抗高血压治疗。在这24个城镇中，测量到的高血压患病率存在三倍的差异，英格兰北部和苏格兰的患病率有上升趋势。城镇中测量到的高血压患病率与医生诊断的高血压患病率之间没有关联。城镇中的心血管死亡率与测量到的收缩期和舒张期高血压患病率相关（分别为r = 0.70和r = 0.57）。英国血压和高血压的地理差异为研究“原发性”高血压的病因提供了一个主要机会。
