Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China.
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Eur J Intern Med. 2023 Jun;112:93-99. doi: 10.1016/j.ejim.2023.03.026. Epub 2023 Mar 29.
Isolated diastolic hypertension (IDH) is recognized as a risk factor for cardiovascular disease, yet its clinical epidemiology remains poorly understood due to insufficient recognition. This study aims to describe the trend in the prevalence, awareness, and treatment of IDH in the United States from 2001 to 2018.
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in nine consecutive two-year cycles from 2001-2002 to 2017-2018, comprising a sample of 48,742 adults aged over 18 years. IDH was defined as a diastolic blood pressure ≥ 80 mm Hg with a systolic BP < 130 mm Hg by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines.
In the nationally representative dataset, 8.9% of participants had IDH in 2017-2018, a decreased of 3.6% (95% confidence interval [CI], -2.6% to -5.0%, P<0.0002) since 2001-2002. IDH prevalence was highest among Mexican American (10.5%), individuals aged 40-59 (12.3%), increased with body mass index (BMI) (11.2% among those BMI ≥30.0 kg/m), and tended to be higher in men (12.3%). A multiple regression analysis showed that men, white race/ethnicity, young and middle-aged people (aged 18-59), and increasing BMI were independently associated with increased risks of IDH. Among IDH patients, there was a modest increase in awareness (P<0.0002), from 22.4% (95%CI, 18.4% to 27.1%) in 2001-2002 to 35.0% (95%CI, 28.2% to 42.5%) in 2017-2018, with the largest percentage increases among non-Hispanic white and men. IDH treatment increased by 7.6% (95%CI, 3.1% to 12.1%) between 2001-2002 and 2017-2018, with the greatest increases occurring in Mexican American and men.
IDH prevalence is decreasing from 2001-2002 to 2017-2018 in the United States. Despite the significantly increased in both awareness and treatment, they remain below 50%.
孤立性舒张期高血压（IDH）已被确认为心血管疾病的危险因素，但由于认识不足，其临床流行病学仍知之甚少。本研究旨在描述 2001 年至 2018 年美国 IDH 的患病率、知晓率和治疗率的趋势。
本横断面研究利用了美国国家健康和营养调查（NHANES）的数据，该调查在 2001-2002 年至 2017-2018 年期间连续进行了 9 个两年周期，样本包括 48742 名年龄在 18 岁以上的成年人。IDH 定义为 2017 年美国心脏病学会（ACC）/美国心脏协会（AHA）指南中舒张期血压≥80mmHg 且收缩压<130mmHg。
在全国代表性数据集中，2017-2018 年有 8.9%的参与者患有 IDH，自 2001-2002 年以来下降了 3.6%（95%置信区间[CI]，-2.6%至-5.0%，P<0.0002）。IDH 的患病率在墨西哥裔美国人中最高（10.5%），年龄在 40-59 岁的人群中最高（12.3%），随着体重指数（BMI）的增加而增加（BMI≥30.0kg/m 时为 11.2%），且男性中倾向于更高。多元回归分析显示，男性、白种人、年轻和中年（18-59 岁）以及 BMI 增加与 IDH 的风险增加独立相关。在 IDH 患者中，知晓率（P<0.0002）有适度增加，从 2001-2002 年的 22.4%（95%CI，18.4%至 27.1%）增加到 2017-2018 年的 35.0%（95%CI，28.2%至 42.5%），其中非西班牙裔白人和男性的百分比增幅最大。IDH 的治疗率从 2001-2002 年到 2017-2018 年增加了 7.6%（95%CI，3.1%至 12.1%），其中增幅最大的是墨西哥裔美国人和男性。
2001-2002 年至 2017-2018 年期间，美国 IDH 的患病率呈下降趋势。尽管知晓率和治疗率显著增加，但仍低于 50%。
