Garrison R J, Kannel W B, Stokes J, Castelli W P
Prev Med. 1987 Mar;16(2):235-51. doi: 10.1016/0091-7435(87)90087-9.
The occurrence of hypertension and its precursors is examined in the Framingham Offspring Study of 2,027 men and 2,267 women ages 20-49 years followed for 8 years. The age-specific prevalence of hypertension was similar at both the first (1971-1975) and the second (1979-1983) examination for both men and women. Prevalence rates were higher among men than among women, and there was a higher rate of hypertension treatment at the second exam, particularly among women, 75% of whom reported being treated for hypertension. The incidence of hypertension in participants free from hypertension at the first examination increased threefold from the second to the fifth age decades in men and eight-fold in women. Under age 40, men were twice as likely as women to develop hypertension, but after age 40, 8-year incidence rates were similar in men (14.2%) and women (12.9%). Adiposity, relative weight, heart rate, alcohol intake, hematocrit, blood sugar, serum protein, triglyceride, and phosphorous were all related to hypertension occurrence in one or both sexes, controlling for age. In multivariate analysis, adiposity (P less than 0.01), heart rate (P less than 0.01), and triglyceride (P less than 0.05) were all significant independent predictors of hypertension in men. In women, adiposity (P less than 0.001), heart rate (P less than 0.01), hematocrit (P less than 0.05), and alcohol consumption (P less than 0.05) were independent contributors. When controlling for blood pressure measured at the first examination, the best single predictor of hypertension incidence, the multivariate assessment changed very little. Adiposity stands out as a major controllable contributor to hypertension. Changes in body fat over 8 years were related to changes in both systolic and diastolic blood pressure. Markedly obese women in their fourth decade were seven times more likely to develop hypertension than were lean women of the same age. Weight control deserves a high priority in efforts to prevent hypertension in the general population.
在弗明汉后代研究中，对2027名年龄在20至49岁之间的男性和2267名同龄女性进行了为期8年的跟踪调查，以研究高血压及其前期症状的发生情况。在第一次检查（1971 - 1975年）和第二次检查（1979 - 1983年）时，按年龄划分的高血压患病率在男性和女性中相似。男性的患病率高于女性，且在第二次检查时高血压治疗率更高，尤其是女性，其中75%的女性报告正在接受高血压治疗。在第一次检查时无高血压的参与者中，高血压发病率在男性从第二个十年到第五个十年增加了两倍，在女性中增加了八倍。40岁以下，男性患高血压的可能性是女性的两倍，但40岁以后，男性（14.2%）和女性（12.9%）的8年发病率相似。在控制年龄因素后，肥胖、相对体重、心率、酒精摄入量、血细胞比容、血糖、血清蛋白、甘油三酯和磷均与男女双方高血压的发生有关。在多变量分析中，肥胖（P小于0.01）、心率（P小于0.01）和甘油三酯（P小于0.05）均是男性高血压的显著独立预测因素。在女性中，肥胖（P小于0.001）、心率（P小于0.01）、血细胞比容（P小于0.05）和酒精摄入量（P小于0.05）是独立的影响因素。在控制第一次检查时测量的血压（高血压发病率的最佳单一预测因素）后，多变量评估变化很小。肥胖是高血压的一个主要可控影响因素。8年期间身体脂肪的变化与收缩压和舒张压的变化均有关。40多岁明显肥胖的女性患高血压的可能性是同龄瘦女性的7倍。在普通人群预防高血压的努力中，控制体重应被置于高度优先地位。
