Division of Precision Medicine, Department of Medicine, NYU Langone Health, New York (W.-J.Y., R.A., A.L.S., C.M.F., M.E.G.).
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (P.S., B.O.).
Hypertension. 2024 Nov;81(11):2263-2274. doi: 10.1161/HYPERTENSIONAHA.124.22980. Epub 2024 Sep 4.
The prevalence of hypertension and uncontrolled hypertension may differ by age and sex.
We included participants in the Atherosclerosis Risk in Communities study at seven study visits over 33 years (visit 1: 15 636 participants; mean age, 54 years; 55% women), estimating sex differences in prevalence of hypertension (systolic blood pressure ≥130 mm Hg; diastolic blood pressure ≥80 mm Hg; or self-reported antihypertension medication use) and uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) using unadjusted and comorbidity-adjusted models.
The prevalence of hypertension increased with age from 40% (ages, 43-46 years) to 93% (ages, 91-94 years). Within hypertensive individuals, the prevalence of uncontrolled hypertension was higher in men (33%) than women (23%) at ages 43 to 46 years but became higher in women than men starting at ages 61 to 64, with 56% of women and 40% men having uncontrolled hypertension at ages 91 to 94. This sex difference was not explained by differences in coronary heart disease, diabetes, body mass index, estimated glomerular filtration rate, number of antihypertension medications, classes of medications, or adherence to medications. In both sexes, uncontrolled hypertension was associated with a higher risk for chronic kidney disease progression (hazard ratio, 1.5 [1.2-1.9]; =4.5×10), heart failure (hazard ratio, 1.6 [1.4-2.0]; =8.1×10), stroke (hazard ratio, 2.1 [1.6-2.8]; =1.8×10), and mortality (hazard ratio, 1.5 [1.3-1.6]; =6.2×10).
Sex differences in the prevalence of hypertension and uncontrolled hypertension vary by age, with the latter having implications for health throughout the life course.
高血压和未控制高血压的患病率可能因年龄和性别而异。
我们纳入了在 33 年的 7 次研究访问中参加动脉粥样硬化风险社区研究的参与者（第 1 次访问：15636 名参与者；平均年龄 54 岁；55%为女性），使用未经调整和合并症调整模型估计高血压（收缩压≥130mmHg；舒张压≥80mmHg；或自我报告使用抗高血压药物）和未控制高血压（收缩压≥140mmHg 或舒张压≥90mmHg）的患病率在性别之间的差异。
高血压的患病率随着年龄的增长而增加，从 40%（年龄 43-46 岁）增加到 93%（年龄 91-94 岁）。在高血压患者中，男性（33%）在 43-46 岁时未控制高血压的患病率高于女性（23%），但从 61-64 岁开始，女性高于男性，91-94 岁时，56%的女性和 40%的男性患有未控制高血压。这种性别差异不能用冠心病、糖尿病、体重指数、估计肾小球滤过率、抗高血压药物的数量、药物类别或药物的依从性来解释。在两性中，未控制高血压与慢性肾脏病进展的风险增加相关（风险比，1.5[1.2-1.9]；=4.5×10），心力衰竭（风险比，1.6[1.4-2.0]；=8.1×10），中风（风险比，2.1[1.6-2.8]；=1.8×10）和死亡率（风险比，1.5[1.3-1.6]；=6.2×10）。
高血压和未控制高血压的患病率在性别之间存在差异，且随年龄变化而变化，后者对整个生命周期的健康都有影响。
