Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia.
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
Am J Hypertens. 2024 Nov 15;37(12):948-952. doi: 10.1093/ajh/hpae108.
There is insufficient evidence of how accurately hypertension is reported on death certificates, which are the primary evidence of causes of death. This study assesses the accuracy of reporting of hypertension on death certificates of decedents in Australia who previously had their blood pressure measured.
Blood pressure data from the 2014-2015 and 2017-2018 National Health Surveys were linked to death registration data from July 2015 to December 2021 (average 3.3 years from survey to death). The percentage of decedents with hypertension reported on the death certificate was calculated according to blood pressure level and previous diagnosis of hypertension.
Hypertension was reported on the death certificate of 20.2% (95% confidence interval 12.1%-28.3%) of decedents who had very high to severe blood pressure (160/100 mm Hg and above), 14.5% (10.3%-18.8%) who had high blood pressure (140 to <160 / 90 to <100 mm Hg), 14.1% (10.8%-17.4%) who had normal to high blood pressure (<140/90 mm Hg) and who took hypertension medication, and 17.8% (13.6%-22.0%) who had been diagnosed with hypertension. Where the decedent had very high to severe blood pressure, hypertension was reported for 27.9% (14.1%-41.8%) of deaths if they had been diagnosed with hypertension, and 21.7% (9.6%-33.7%) where another cardiovascular disease was reported on the death certificate.
Hypertension mortality in Australia is only reported for a minority of deaths of people with high or very high to severe blood pressure; this is also found for those with a prior diagnosis of hypertension.
高血压在死亡证明上的报告准确性证据不足，而死亡证明是死因的主要证据。本研究评估了澳大利亚既往血压测量死者的死亡证明上高血压报告的准确性。
将 2014-2015 年和 2017-2018 年全国健康调查的血压数据与 2015 年 7 月至 2021 年 12 月（从调查到死亡的平均时间为 3.3 年）的死亡登记数据相链接。根据血压水平和既往高血压诊断，计算有高血压报告的死者在死亡证明上的比例。
报告有非常高至重度高血压（160/100mmHg 及以上）的死者中，有 20.2%（95%置信区间 12.1%-28.3%）的死者在死亡证明上报告有高血压，报告有高血压（140-<160/90-<100mmHg）的死者中，有 14.5%（10.3%-18.8%）的死者在死亡证明上报告有高血压，报告有正常至高血压（<140/90mmHg）且正在服用高血压药物的死者中，有 14.1%（10.8%-17.4%）的死者在死亡证明上报告有高血压，报告有高血压诊断的死者中，有 17.8%（13.6%-22.0%）的死者在死亡证明上报告有高血压。如果死者有非常高至重度高血压，且被诊断为高血压，那么高血压在死因中占 27.9%（14.1%-41.8%）；如果死亡证明上报告了另一种心血管疾病，那么高血压在死因中占 21.7%（9.6%-33.7%）。
澳大利亚只有少数有高或非常高至重度高血压的死者的高血压死亡率被报告；对于有高血压诊断的死者也是如此。
