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墨西哥动脉高血压患者:墨西哥动脉高血压登记研究(RIHTA 研究)的初步见解。

Patients Living With Arterial Hypertension in Mexico: First Insights of The Mexican Registry of Arterial Hypertension (RIHTA Study).

机构信息

Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México.

Grupo Colaborativo en Hipertensión Arterial (GCHTA), Ciudad de México, México.

出版信息

Am J Hypertens. 2024 Jun 14;37(7):503-513. doi: 10.1093/ajh/hpae024.

Abstract

BACKGROUND

Arterial hypertension is a significant cause of morbidity and mortality in Mexico. However, there is limited evidence to understand blood pressure management and cardiometabolic profiles. Here, we aim to assess the prevalence of controlled and uncontrolled blood pressure, as well as the prevalence of cardiometabolic risk factors among patients from the Mexican Registry of Arterial Hypertension (RIHTA).

METHODS

We conducted a cross-sectional analysis of participants living with arterial hypertension registered on RIHTA between December 2021 and April 2023. We used both the 2017 ACC/AHA and 2018 ESC/ESH thresholds to define controlled and uncontrolled arterial hypertension. We considered eleven cardiometabolic risk factors, which include overweight, obesity, central obesity, insulin resistance, diabetes, hypercholesterolemia, hypertriglyceridemia, low HDL-C, high LDL-C, low-eGFR, and high cardiovascular disease (CVD) risk.

RESULTS

In a sample of 5,590 participants (female: 61%, n = 3,393; median age: 64 [IQR: 56-72] years), the prevalence of uncontrolled hypertension varied significantly, depending on the definition (2017 ACC/AHA: 59.9%, 95% CI: 58.6-61.2 and 2018 ESC/ESH: 20.1%, 95% CI: 19.0-21.2). In the sample, 40.43% exhibited at least 5-6 risk factors, and 32.4% had 3-4 risk factors, chiefly abdominal obesity (83.4%, 95% CI: 82.4-84.4), high LDL-C (59.6%, 95% CI: 58.3-60.9), high CVD risk (57.9%, 95% CI: 56.6-59.2), high triglycerides (56.2%, 95% CI: 54.9-57.5), and low HDL-C (42.2%, 95% CI: 40.9-43.5).

CONCLUSIONS

There is a high prevalence of uncontrolled hypertension interlinked with a high burden of cardiometabolic comorbidities in Mexican adults living with arterial hypertension, underscoring the urgent need for targeted interventions and better healthcare policies to reduce the burden of the disease in our country.

摘要

背景

动脉高血压是墨西哥发病率和死亡率的重要原因。然而,目前证据有限,难以了解血压管理和心血管代谢特征。在此,我们旨在评估墨西哥动脉高血压登记处(RIHTA)患者中血压控制和未控制的患病率,以及心血管代谢危险因素的患病率。

方法

我们对 2021 年 12 月至 2023 年 4 月期间登记在 RIHTA 的动脉高血压患者进行了横断面分析。我们使用 2017 年 ACC/AHA 和 2018 年 ESC/ESH 标准来定义血压控制和未控制的动脉高血压。我们考虑了 11 种心血管代谢危险因素,包括超重、肥胖、中心性肥胖、胰岛素抵抗、糖尿病、高胆固醇血症、高三酰甘油血症、低 HDL-C、高 LDL-C、低 eGFR 和高心血管疾病(CVD)风险。

结果

在 5590 名参与者(女性:61%,n=3393;中位数年龄:64[IQR:56-72]岁)中,根据定义,血压未控制的患病率差异显著(2017 年 ACC/AHA:59.9%,95%CI:58.6-61.2 和 2018 年 ESC/ESH:20.1%,95%CI:19.0-21.2)。在该样本中,40.43%的患者至少有 5-6 种危险因素,32.4%的患者有 3-4 种危险因素,主要是腹部肥胖(83.4%,95%CI:82.4-84.4)、高 LDL-C(59.6%,95%CI:58.3-60.9)、高 CVD 风险(57.9%,95%CI:56.6-59.2)、高三酰甘油血症(56.2%,95%CI:54.9-57.5)和低 HDL-C(42.2%,95%CI:40.9-43.5)。

结论

在墨西哥成年动脉高血压患者中,血压未控制的患病率很高,同时伴有心血管代谢合并症的负担很重,这突显了我们迫切需要采取有针对性的干预措施和更好的医疗保健政策,以减轻我国的疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f367/11176274/4ddb24d3c40e/hpae024_fig5.jpg

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