Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, Buffalo, New York, USA.
J Clin Hypertens (Greenwich). 2024 Oct;26(10):1171-1180. doi: 10.1111/jch.14889. Epub 2024 Aug 19.
Few studies have reported on the accuracy of self-reported hypertension history among older postmenopausal women, which was this study's objective. Participants were postmenopausal women enrolled in the Osteoporosis and Periodontal Disease (OsteoPerio) study, an ancillary investigation of the Women's Health Initiative Observational Study (WHI-OS) at the Buffalo, New York, clinical site. Participants self-reported their history of physician diagnosed hypertension treated with medication at WHI-OS enrollment (1993-1998; n = 1342, mean age 63 years), then 3 years later at OsteoPerio enrollment (1997-2001; n = 1342), and again at OsteoPerio Year 5 follow-up (2002-2005; n = 1020). At each time point, medication inventories were recorded and served as the criterion with which self-report was compared in the present study. Physician diagnosed-treated hypertension was also self-reported annually on mailed health update questionnaires in the WHI-OS and were compared against medication inventory at the subsequent clinic exam. Of those participants who self-reported a history of hypertension at WHI enrollment, OsteoPerio enrollment, and OsteoPerio Year 5 follow-up, 41.2%, 90.3%, and 94.4%, respectively, had anti-hypertensive pills in their medication inventory. Across the three time points, sensitivity and specificity ranged from 0.72 to 0.98 and from 0.85 to 0.95, and kappa coefficients ranged from 0.52 to 0.79 when comparing self-report with medication inventory. For self-reported newly physician-diagnosed and treated hypertension on the annual health update questionnaire, 88.4% and 95.2% of those reporting hypertension had anti-hypertensive pills in the subsequent medication inventory. In general, sensitivity and kappa were lower in women aged ≥70 versus < 70 years and in those with history of cardiovascular disease and diabetes compared to those without these comorbidities. In this cohort of postmenopausal women, self-reported physician diagnosed and treated hypertension demonstrated moderate to high accuracy when compared against anti-hypertensive medication use documented by pill inventory, particularly for those who were younger and managing fewer comorbidities.
很少有研究报告绝经后老年女性自我报告的高血压病史的准确性，这是本研究的目的。参与者为参加纽约水牛城骨质疏松症和牙周病（OsteoPerio）研究的绝经后女性，这是妇女健康倡议观察研究（WHI-OS）的辅助研究。参与者在 WHI-OS 登记时（1993-1998 年；n=1342，平均年龄 63 岁）自我报告其曾被医生诊断为高血压并接受药物治疗的病史，然后在 OsteoPerio 登记时（1997-2001 年；n=1342）再次报告，然后在 OsteoPerio 第 5 年随访时（2002-2005 年；n=1020）再次报告。在每个时间点，都记录了药物清单，并在本研究中作为与自我报告进行比较的标准。每年在 WHI-OS 的邮寄健康更新问卷中也会自我报告被医生诊断为高血压并接受治疗的情况，并与随后的临床检查中的药物清单进行比较。在 WHI 登记、OsteoPerio 登记和 OsteoPerio 第 5 年随访时自我报告高血压病史的参与者中，分别有 41.2%、90.3%和 94.4%的人在药物清单中含有抗高血压药物。在三个时间点上，敏感性和特异性范围分别为 0.72 至 0.98 和 0.85 至 0.95，当将自我报告与药物清单进行比较时，kappa 系数范围为 0.52 至 0.79。对于年度健康更新问卷中自我报告的新被医生诊断和治疗的高血压，报告高血压的人中 88.4%和 95.2%在随后的药物清单中含有抗高血压药物。一般来说，年龄≥70 岁的女性与<70 岁的女性相比，以及有心血管疾病和糖尿病病史的女性与没有这些合并症的女性相比，敏感性和 kappa 值较低。在这个绝经后女性队列中，与抗高血压药物使用的药物清单相比，自我报告的被医生诊断和治疗的高血压具有中等至高度的准确性，尤其是对于那些年龄较小且合并症较少的女性。
