Sjøl A, Thomsen K K, Schroll M
Centre of Preventive Medicine, Department of Internal Medicine C, University Hospital of Copenhagen, Glostrup, Denmark.
Int J Epidemiol. 1998 Aug;27(4):614-22. doi: 10.1093/ije/27.4.614.
Hypertension is an essential risk factor for development of cardiovascular diseases. Prospective studies show a reduction in risk of myocardial infarction with reduction of blood pressure. In Denmark there was a decrease in ischaemic heart disease mortality during the period (1968-1992) with around 34% in 30-65 year old men and 30% in women.
To assess the changes in casual blood pressure between 1964 and 1991 in seven cross-sectional population studies.
Centre of Preventive Medicine, University of Copenhagen, DK-2600 Glostrup.
10359 subjects, equal numbers of men and women, age exactly 30, 40, 50 and 60 years drawn as random samples from a background population of 300000 inhabitants and surveyed in 1964-1974 and five cross-sectional studies 1976, 1978, 1982-1984, 1986-1987 and 1991.
Blood pressure was measured according to WHO criteria by one technician in each survey. Alcohol consumption and physical activity were measured by a self-administered questionnaire. The weight and height were measured by standardized methods. Data on mortality from ischaemic heart disease were obtained from death certificates recorded by the National Board of Health.
Blood pressure increased with increasing age in both genders and was significantly higher in men than in women. Median blood pressure in 50 year old men in 1964 was 135/85 mmHg and in 1991 it was 123/79, whereas in women in 1964 it was 140/85, against 119/74 in 1991. The prevalence of hypertensives among 30 and 40 year olds declined throughout the period. The performance of blood pressure measurements, technical variation, examination programme, seasonal variation and inter-observer variation were potential bias sources and influenced blood pressure levels, but cannot be shown to be responsible for the declining trend in blood pressure and hypertension. Women became a little more physical active in leisure time and men less active. Women consumed less alcohol than men, but the amounts slightly increased by the end of the period. Body mass index >25 was seen less frequently in women than in men and this increased in men over the period. Sale of antihypertensive drugs increased in Denmark over the 1964-1991 period. There seems to be good agreement between the changes in blood pressure in the population and the decline in mortality from stroke and coronary heart disease in Denmark, which is influenced by other risk factors as well.
Blood pressure distributions have shifted towards lower values in 1964-1991. Prevalence of hypertension declined up to 1983. Risk factor changes as well as treatment for hypertension contribute to this.
高血压是心血管疾病发生的重要危险因素。前瞻性研究表明，血压降低可降低心肌梗死风险。在丹麦，（1968 - 1992年）期间缺血性心脏病死亡率有所下降，30 - 65岁男性下降了约34%，女性下降了30%。
评估七项横断面人群研究中1964年至1991年期间偶测血压的变化。
哥本哈根大学预防医学中心，丹麦格罗斯特鲁普2600。
10359名受试者，男女数量相等，年龄分别为30、40、50和60岁，从30万居民的背景人群中随机抽取，并于1964 - 1974年以及1976年、1978年、1982 - 1984年、1986 - 1987年和1991年进行了五项横断面研究。
每次调查由一名技术人员按照世界卫生组织标准测量血压。通过自我填写问卷测量酒精摄入量和身体活动情况。采用标准化方法测量体重和身高。缺血性心脏病死亡率数据来自国家卫生局记录的死亡证明。
男女血压均随年龄增长而升高，男性血压显著高于女性。1964年50岁男性的血压中位数为135/85 mmHg，1991年为123/79 mmHg；而1964年女性的血压中位数为140/85 mmHg，1991年为119/74 mmHg。30岁和40岁人群中高血压患病率在此期间持续下降。血压测量的操作、技术差异、检查程序、季节变化和观察者间差异均为潜在的偏倚来源，并影响血压水平，但无法证明它们是导致血压和高血压下降趋势的原因。女性在休闲时间的身体活动略有增加，而男性则减少。女性饮酒量少于男性，但在该时期末略有增加。体重指数>25的情况在女性中比男性中少见，且在此期间男性有所增加。1964 - 1991年期间丹麦抗高血压药物的销售量增加。丹麦人群血压变化与中风和冠心病死亡率下降之间似乎有很好的一致性，当然这也受到其他危险因素的影响。
1964 - 1991年期间血压分布已向较低值偏移。高血压患病率在1983年前下降。危险因素的变化以及高血压治疗对此都有贡献。
