Whelton P K
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Hospital, Baltimore, Maryland 21287-6231.
Lancet. 1994 Jul 9;344(8915):101-6. doi: 10.1016/s0140-6736(94)91285-8.
Cardiovascular disease is the main cause of death in virtually all industrialised countries. The limited information available from developing countries suggests that a similar epidemic is inevitable if current trends go unchecked. Treatment of patients with clinical manifestations is an important element in overall management but on its own is an insufficient and incomplete response. Sudden death is often the first manifestation of cardiovascular disease and, even when treatment of disease is applicable and effective, it is usually palliative rather than curative. Thus treatment and prevention directed at the underlying risk factors, including high blood pressure, constitute a complementary and more fundamental approach to reducing the burden of illness. Epidemiological studies provide the scientific foundation for such an approach by identifying the distribution and determinants of high blood pressure in the general population, by establishing the role of high blood pressure as a risk factor for cardiorenal complications, and by quantifying the potential value of treating and preventing high blood pressure in the general population.
心血管疾病几乎是所有工业化国家的主要死因。来自发展中国家的有限信息表明,如果当前趋势得不到遏制,类似的流行将不可避免。对有临床表现的患者进行治疗是整体管理的重要组成部分,但仅靠治疗本身是一种不足且不完整的应对措施。猝死往往是心血管疾病的首发表现,即使疾病治疗适用且有效,通常也只是姑息性的而非治愈性的。因此,针对包括高血压在内的潜在危险因素进行治疗和预防,是减轻疾病负担的一种补充且更根本的方法。流行病学研究通过确定普通人群中高血压的分布和决定因素、确立高血压作为心肾并发症危险因素的作用,以及量化在普通人群中治疗和预防高血压的潜在价值,为这种方法提供了科学依据。