Department of Chronic and Non-Infection Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention, Mingshi Road No.568, Hangzhou, 310021, China.
Gongshu District Center for Disease Control and Prevention, Hangzhou, China.
Sci Rep. 2021 Sep 24;11(1):19066. doi: 10.1038/s41598-021-98745-8.
The present study aimed to describe the blood pressure (BP) control rate and 10-years arteriosclerotic cardiovascular disease (ASCVD) risk estimation among community hypertensive patients. A total of 196,803 subjects were enrolled. The control rates calculated as the intensive (SBP < 130 mmHg and DBP < 80 mmHg) and standard (SBP < 140 mmHg and DBP < 90 mmHg) threshold. Multivariable logistic analysis was employed to assess the associations between cardiovascular factors and BP control. Sensitivity, specificity and Youden's index were used to identify the ability of high risk of ASCVD estimation by different thresholds. The control rate was 16.34% and 50.25% by the intensive and standard threshold, respectively. Besides regular medication, the risk factors for BP control included older age, male, unhealthy lifestyle, obesity, dyslipidemia and abnormal FPG. 25.08% of subjects had high risk of 10-years ASCVD estimation. The sensitivity, specificity and Youden's index of intensive threshold was 84.37%, 16.15% and 0.51%, and were significantly different from 50.55%, 50.42% and 0.98% of the standard threshold, respectively. Half of community hypertensive patients did not control BP, and nearly a quarter have high risk of 10-years ASCVD risk estimation. The intensive threshold resulted in a one-third reduction in the control rate compared to the standard threshold. No matter which threshold was used, a single BP control status seemed not a suitable indicator for identification of high risk of 10-years ASCVD risk estimation.
本研究旨在描述社区高血压患者的血压(BP)控制率和 10 年动脉粥样硬化性心血管疾病(ASCVD)风险评估。共纳入 196803 例患者。采用强化(SBP<130mmHg 和 DBP<80mmHg)和标准(SBP<140mmHg 和 DBP<90mmHg)阈值来计算控制率。采用多变量逻辑分析评估心血管因素与 BP 控制之间的关系。采用灵敏度、特异性和 Youden 指数评估不同阈值下 ASCVD 高危风险评估的能力。强化和标准阈值的控制率分别为 16.34%和 50.25%。除了常规药物治疗外,BP 控制的危险因素还包括年龄较大、男性、不健康的生活方式、肥胖、血脂异常和异常 FPG。25.08%的患者有 10 年 ASCVD 高危风险。强化阈值的灵敏度、特异性和 Youden 指数分别为 84.37%、16.15%和 0.51%,与标准阈值的 50.55%、50.42%和 0.98%相比,差异有统计学意义。一半的社区高血压患者没有控制血压,近四分之一的患者有 10 年 ASCVD 高危风险。与标准阈值相比,强化阈值使控制率降低了三分之一。无论使用哪个阈值,单一的 BP 控制状态似乎都不是识别 10 年 ASCVD 高危风险的合适指标。