Trenkwalder P, Ruland D, Stender M, Gebhard J, Trenkwalder C, Lydtin H, Hense H W
Department of Internal Medicine, Starnberg Hospital, Germany.
J Hypertens. 1994 Jun;12(6):709-16. doi: 10.1097/00004872-199406000-00012.
To assess the prevalence of hypertension and isolated systolic hypertension and the level of awareness, treatment and control of hypertension, in a population aged over 65 years.
Cross-sectional survey of the total population aged > or = 65 years of two Bavarian villages with a representative age distribution.
From a total of 1190 inhabitants aged > or = 65 years, 982 (394 male, 588 female) participated (response rate 82.5%).
All of the participants were visited at home by physician observers. After a standardized questionnaire, blood pressure was measured three times on one occasion with the subject in the sitting position, using a standard mercury sphygmomanometer. 'Actual' hypertension was defined as systolic blood pressure (SBP) > or = 160 or diastolic blood pressure (DBP) > or = 95 mmHg, or both, or current use of antihypertensive drugs given for the indication hypertension in patients with blood pressure < 160/95 mmHg. Isolated systolic hypertension was defined as SBP > or = 160 and DBP < 90 mmHg. All 'actual' hypertensives were further classified as 'unaware' of hypertension, 'aware' (but not treated), 'treated' (current use of antihypertensive drugs for the indication hypertension and blood pressure > or = 160/95 mmHg) or 'controlled' (treated and blood pressure < 160/95 mmHg).
Mean +/- SD blood pressure was 154.5 +/- 24.4/84.9 +/- 11.6 mmHg (when 52 institutionalized participants were excluded, 155.6 +/- 24.4/85.3 +/- 11.6 mmHg). The SBP was significantly higher in females than in males and increased up to the age group 80-84 years both in males and in females. The DBP decreased with age. The prevalence of 'actual' hypertension was 53% and increased up to the age group 75-79 years in males and 80-84 years in females. The prevalence of isolated systolic hypertension was 17% (with patients currently using antihypertensive drugs excluded). Of the patients with 'actual' hypertension, 34% were 'unaware' of the diagnosis, 12% 'aware', 32% 'treated' and 22% 'controlled'.
In central Europe hypertension, with a prevalence of > 50%, remains the most common cardiovascular risk factor in the elderly. Although most elderly hypertensives are currently treated with antihypertensive agents, less than one-quarter are controlled, and more than one-third are still unaware of the diagnosis. These levels of awareness and control call for better strategies in the diagnosis and treatment of hypertension in the elderly.
评估65岁以上人群中高血压及单纯收缩期高血压的患病率，以及高血压的知晓率、治疗率和控制率。
对两个巴伐利亚村庄年龄分布具有代表性的65岁及以上总人口进行横断面调查。
在1190名65岁及以上居民中，982人（男性394人，女性588人）参与调查（应答率82.5%）。
医生观察员到所有参与者家中进行访视。在完成标准化问卷调查后，让受试者坐位，使用标准汞柱式血压计测量一次血压，共测量三次。“实际”高血压定义为收缩压（SBP）≥160或舒张压（DBP）≥95 mmHg，或两者均符合，或血压<160/95 mmHg的患者当前正在使用用于高血压指征的降压药物。单纯收缩期高血压定义为SBP≥160且DBP<90 mmHg。所有“实际”高血压患者进一步分为对高血压“ unaware”（未意识到）、“ aware”（意识到但未治疗）、“ treated”（当前正在使用用于高血压指征的降压药物且血压≥160/95 mmHg）或“ controlled”（接受治疗且血压<160/95 mmHg）。
平均±标准差血压为154.5±24.4/84.9±11.6 mmHg（排除52名住院参与者后为155.6±24.4/85.3±11.6 mmHg）。女性的收缩压显著高于男性，且在男性和女性中均随年龄增长至80 - 84岁年龄组而升高。舒张压随年龄下降。“实际”高血压患病率为53%，在男性中随年龄增长至75 - 79岁年龄组，在女性中至80 - 84岁年龄组患病率升高。单纯收缩期高血压患病率为17%（排除当前正在使用降压药物的患者）。在“实际”高血压患者中，34%对诊断“ unaware”，12%“ aware”，32%“ treated”，22%“ controlled”。
在中欧，高血压患病率>50%，仍然是老年人中最常见的心血管危险因素。尽管目前大多数老年高血压患者接受了降压药物治疗，但不到四分之一的患者血压得到控制，超过三分之一的患者仍未意识到自己患有高血压。这些知晓率和控制率水平要求在老年人高血压的诊断和治疗方面采取更好的策略。
