Ringwald-de Meyer Sara, de La Harpe Roxane, Vollenweider Peter, Marques-Vidal Pedro, Vaucher Julien
Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Department of Medicine and Specialties, Service of Internal Medicine, Fribourg Hospital and University of Fribourg, Ch. des Pensionnats 2-6, 1708, Fribourg, Switzerland.
Sci Rep. 2025 Jan 2;15(1):375. doi: 10.1038/s41598-024-84824-z.
We aimed to identify and validate factors related to uncontrolled hypertension. Participants treated with at least one antihypertensive drug from the prospective contemporaneous CoLaus|PsyCoLaus study were enrolled. We investigated the association between hypertension status (uncontrolled, defined as systolic blood pressure [SBP] ≥ 140 mm Hg and/or diastolic blood pressure [DBP] ≥ 90 mm Hg, versus controlled hypertension [SBP/DBP < 140/90 mm Hg]) and potential risk factors. Additionally, the prospective association of uncontrolled hypertension with cardiovascular disease and all-cause mortality was evaluated. 1040 participants recruited between 2003 and 2006 with a mean follow-up of 12.3 years (SD ± 3.4) were included in the analyses. Heavy alcohol consumption, increased BMI, increased ferritin and albuminuria were positively associated with uncontrolled hypertension. Factors inversely associated with uncontrolled hypertension were university degree, current smoker, and high potassium urinary excretion. Uncontrolled hypertension status was not associated with incident ASCVD nor all-cause mortality in our study. In conclusion, uncontrolled hypertension was associated with modifiable factors, such as heavy drinking, obesity and level of education. Further studies should investigate whether including biological markers in clinical practice, such as potassium excretion, ferritin levels, or albuminuria, would help identify individuals who may develop uncontrolled hypertension.
我们旨在识别和验证与高血压控制不佳相关的因素。纳入了来自前瞻性同期CoLaus|PsyCoLaus研究中接受至少一种抗高血压药物治疗的参与者。我们研究了高血压状态（未控制，定义为收缩压[SBP]≥140 mmHg和/或舒张压[DBP]≥90 mmHg，与控制良好的高血压[SBP/DBP < 140/90 mmHg]相比）与潜在危险因素之间的关联。此外，还评估了未控制的高血压与心血管疾病和全因死亡率的前瞻性关联。分析纳入了2003年至2006年招募的1040名参与者，平均随访12.3年（标准差±3.4）。大量饮酒、体重指数增加、铁蛋白升高和蛋白尿与未控制的高血压呈正相关。与未控制的高血压呈负相关的因素有大学学历、当前吸烟者和高钾尿排泄。在我们的研究中，未控制的高血压状态与动脉粥样硬化性心血管疾病（ASCVD）的发生及全因死亡率均无关。总之，未控制的高血压与可改变的因素有关，如大量饮酒、肥胖和教育程度。进一步的研究应调查在临床实践中纳入生物标志物，如钾排泄、铁蛋白水平或蛋白尿，是否有助于识别可能发生未控制高血压的个体。
