Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
Alimentary Tract Research Center, Imam Khomeini Hospital Clinical Research Development Unit, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Popul Health Metr. 2021 May 25;19(1):26. doi: 10.1186/s12963-021-00260-5.
In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control, and determinants of hypertension based on this guideline in Khuzestan province, southwest of Iran, and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention.
This population-based cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential relating factors of hypertension was collected, blood pressure was measured, and anthropometric measurements were obtained. Moreover, the dietary pattern was evaluated in 2830 individuals, using a qualitative food frequency questionnaire.
Among 30,506 participants, 30,424 individuals aged 20-65 years were eligible for the study. In comparison with the previous guideline released by the Joint National Committee (JNC8), the prevalence of hypertension in Khuzestan dramatically increased from 15.81 to 42.85% after implementation of the ACC/AHA guideline, which was more dominant in the male population and the 45-54 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The percentage of hypertension awareness, treatment, and control were 45.85%, 35.42%, and 59.63%, which dropped to 22.72%, 26.37%, and 28.94% after implementation of new guideline, respectively.
In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition were shifted into the hypertension category and the level of awareness, treatment, and control were dramatically decreased, which highlight a great need to expand the public health infrastructure for further managing the substantial increased burden on healthcare system. However, further studies with population over 65 years are required to estimate the eligibility for antihypertensive treatment in this province after implementation of new guideline.
2017 年，美国心脏病学会/美国心脏协会（ACC/AHA）发布了高血压预防和管理新指南。我们旨在根据该指南更新伊朗西南部胡齐斯坦省高血压的流行率、知晓率、控制率和决定因素，并估计适合进行非药物和药物干预的人数。
这是一项基于人群的横断面研究，在伊朗西南部的一个大省胡齐斯坦进行。收集了有关高血压相关因素的综合信息，测量了血压，并进行了人体测量。此外，使用定性食物频率问卷评估了 2830 人的饮食模式。
在 30506 名参与者中，有 30424 名年龄在 20-65 岁的人符合研究条件。与之前由联合国家委员会（JNC8）发布的指南相比，在实施 ACC/AHA 指南后，胡齐斯坦省的高血压患病率从 15.81%急剧上升至 42.85%，这在男性和 45-54 岁年龄组中更为明显。对高血压患病率进行性别和年龄调整后，估计患病率为 39.40%。高血压知晓率、治疗率和控制率分别为 45.85%、35.42%和 59.63%，实施新指南后分别降至 22.72%、26.37%和 28.94%。
在 ACC/AHA 指南中，更多的高血压前期患者被归入高血压范畴，知晓率、治疗率和控制率大幅下降，这突显了扩大公共卫生基础设施的迫切需要，以进一步管理医疗保健系统中大幅增加的负担。然而，需要对 65 岁以上人群进行进一步研究，以估计在实施新指南后该省降压治疗的适宜性。
