Yang Chao, Wang Jinwei, Gao Bixia, Zhang Yan, Wang Fang, Zhang Luxia, Zhao Minghui, Huo Yong
Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing 100034, China.
Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
Sci Bull (Beijing). 2018 Apr 30;63(8):488-493. doi: 10.1016/j.scib.2018.03.006. Epub 2018 Mar 15.
The definition, recommended treatment thresholds and targets of hypertension have been updated in the recent 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. However, the impacts of this guideline on Chinese population are currently unknown. In this study, we aim to provide updated data in China using criteria from the updated guideline. A multistage, stratified sampling method was used to obtain a representative sample of 50,171 adults aged 18 years and above. Hypertension was defined as an average systolic blood pressure ≥130 mm Hg, or an average diastolic blood pressure ≥80 mm Hg, or self-reported use of antihypertensive medications in past 2 weeks. The weighted prevalence of hypertension was 60.1% (95% confidence interval [CI] 59.3%-61.0%). The treatment rate and recommended treatment rate were 16.8% (95% CI 16.1%-17.6%) and 53.7% (95% CI 52.6%-54.9%), respectively; the gap was more prominent among men and participants from rural areas. Hence, the adoption of the 2017 ACC/AHA guideline will lead to a substantial increase in both prevalence and number of patients needing treatment in China. The applicability of this guideline should be carefully evaluated based on evidence from Chinese population.
2017年美国心脏病学会/美国心脏协会（ACC/AHA）发布的《成人高血压预防、检测、评估和管理指南》更新了高血压的定义、推荐治疗阈值和目标。然而，该指南对中国人群的影响目前尚不清楚。在本研究中，我们旨在使用更新后的指南标准提供中国的最新数据。采用多阶段分层抽样方法，选取了50171名18岁及以上成年人作为代表性样本。高血压定义为平均收缩压≥130 mmHg，或平均舒张压≥80 mmHg，或在过去2周内自述使用过降压药物。高血压加权患病率为60.1%（95%置信区间[CI] 59.3%-61.0%）。治疗率和推荐治疗率分别为16.8%（95% CI 16.1%-17.6%）和53.7%（95% CI 52.6%-54.9%）；男性和农村地区参与者之间的差距更为突出。因此，采用2017年ACC/AHA指南将导致中国高血压患病率和需要治疗的患者数量大幅增加。应根据中国人群的证据仔细评估该指南的适用性。
