Marques-Vidal P, Tuomilehto J
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
J Hum Hypertens. 1997 Apr;11(4):213-20. doi: 10.1038/sj.jhh.1000426.
One of the cornerstones of the primary prevention of cardiovascular disease has been screening and early antihypertensive drug treatment of patients with high blood pressure (BP). Nevertheless, recent population studies have shown that awareness and management of high BP levels are far from optimal. In this study, we performed a search for publications providing frequencies of hypertension awareness, treatment and control in different populations. In men, the frequencies of awareness, antihypertensive drug treatment and BP control among all hypertensive patients varied between 23% and 93%, 5% and 89% and 5% and 87%, respectively. In women, the frequencies ranged between 28% and 97%, 6% and 97%, and 0% and 97%, respectively. The percentage of aware hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of treated hypertensives achieving an adequate BP control varied between 29% and 95% in men and between 0% and 100% in women. Overall, women had a better awareness, treatment and control status for hypertension than men, and worse in developing countries than in industrialised countries. Hypertension awareness, treatment and control improved with time, together with the proportion of diagnosed hypertensive patients under treatment and the proportion of well controlled among treated hypertensive patients. We conclude that although the 'rule of halves' no longer applies for screening and treatment of hypertension in industrialised countries, it might still be valid for developing countries and for the effectiveness of antihypertensive drug treatment in all countries.
心血管疾病一级预防的基石之一一直是对高血压患者进行筛查和早期抗高血压药物治疗。然而，最近的人群研究表明，高血压水平的知晓率和管理情况远未达到最佳状态。在本研究中，我们检索了提供不同人群高血压知晓率、治疗率和控制率的出版物。在男性中，所有高血压患者的知晓率、抗高血压药物治疗率和血压控制率分别在23%至93%、5%至89%以及5%至87%之间。在女性中，这些比率分别在28%至97%、6%至97%以及0%至97%之间。接受抗高血压药物治疗的知晓高血压患者的百分比在男性中为47%至95%，在女性中为50%至100%。接受抗高血压药物治疗的高血压患者的百分比在男性中为47%至95%，在女性中为50%至100%。血压得到充分控制的接受治疗高血压患者的百分比在男性中为29%至95%，在女性中为0%至100%。总体而言，女性在高血压的知晓、治疗和控制状况方面优于男性，而在发展中国家则比工业化国家差。高血压的知晓、治疗和控制情况随时间有所改善，接受治疗的确诊高血压患者比例以及接受治疗的高血压患者中控制良好的比例也有所提高。我们得出结论，尽管在工业化国家“一半法则”不再适用于高血压筛查和治疗，但在发展中国家可能仍然有效，并且在所有国家抗高血压药物治疗的有效性方面也可能仍然有效。
