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捷克共和国25至64岁健康和不健康个体的高血压护理级联。

Cascade of care for hypertension among apparently healthy and unhealthy individuals of 25-64 years in the Czech Republic.

作者信息

Berka Barbora, Lustigová Michala, Urbanová Jana, Krollová Pavlína, Hloch Ondřej, Romanová Alexandra, Michalec Juraj, Taniwall Arian, Žejglicová Kristýna, Malinovská Jana, Jenšovský Michael, Vejtasová Veronika, González-Rivas Juan P, Maranhao Neto Geraldo A, Pavlovska Iuliia, Brož Jan

机构信息

Department of Internal Medicine University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic.

Department of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech Republic.

出版信息

PLoS One. 2024 Apr 25;19(4):e0301202. doi: 10.1371/journal.pone.0301202. eCollection 2024.

Abstract

BACKGROUND

Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals.

OBJECTIVE

The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases.

METHODS

Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents.

RESULTS

The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant.

CONCLUSIONS

Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

摘要

背景

尽管高血压的诊断和治疗方法易于获得,但全球仍有很大比例的患者未意识到自己的病情,甚至更多患者未接受治疗。多项研究表明,无合并症是高血压未被察觉并因此未得到治疗的一个预测因素。仅有少数研究评估了看似健康个体中的高血压患病率及管理情况。

目的

本研究旨在评估和比较看似健康的个体、内科疾病患者和非内科疾病患者中的高血压患病率、知晓率、治疗率和控制率。

方法

分析了2014年捷克欧洲健康检查调查期间进行的标准化血压测量数据,以及2014年捷克欧洲健康访谈调查期间收集的健康状况和医疗保健使用信息。我们重点关注25至64岁的参与者。数据按性别和年龄进行加权,以确保人群具有适当的性别和年龄结构。采用χ2检验和二元逻辑回归分析来比较受访者健康状况组之间高血压治疗级联的分布情况。

结果

最终符合条件的样本包括1121名参与者。健康组的高血压患病率为32.8%,非内科疾病组为29.8%,内科疾病组为52.4%,(p<0.001)。知晓率分别为54.1%、59.1%和85.2%,(p<0.001)。治疗率分别为44.2%、52.6%和86.4%,(p<0.001)。在看似健康的受访者中,62.6%的人在过去一年由医疗专业人员测量过血压,非内科疾病组为71.1%,内科疾病组为91.7%,(p<0.001)。高血压控制方面的差异无统计学意义。

结论

总体而言,我们的数据显示捷克人群在高血压管理方面存在不一致。看似健康的个体对自己的诊断知晓率最低,且其中未接受治疗的比例最高。

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The global epidemiology of hypertension.高血压的全球流行病学。
Nat Rev Nephrol. 2020 Apr;16(4):223-237. doi: 10.1038/s41581-019-0244-2. Epub 2020 Feb 5.

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