诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (03): 297-304.doi: 10.16150/j.1671-2870.2024.03.007
收稿日期:
2024-04-15
接受日期:
2024-05-08
出版日期:
2024-06-25
发布日期:
2024-06-25
通讯作者:
李燕,E-mail: liyanshcn@163.com基金资助:
Received:
2024-04-15
Accepted:
2024-05-08
Published:
2024-06-25
Online:
2024-06-25
摘要:
2023年,世界卫生组织(World Health Organization ,WHO)发布了首个《全球高血压报告—与无声杀手的赛跑》,报告涵盖了全球高血压的流行情况和管理方法,分析了高血压导致的死亡及疾病负担,探讨了高血压的危险因素,评价了降压治疗的成本效益,并介绍了多国高血压管理的成功案例,尤其是HEARTS高血压防控计划的全球推广情况。高血压是一个全球性公共卫生挑战,严重危害健康。过去30多年间,全球高血压(收缩压≥140 mmHg,或舒张压≥90 mmHg,或服用降压药物)患者的数量翻了一倍,从1990年的6.5亿增长至2019年的13亿,在30~79岁的全球高血压患者中,大约54%诊断为高血压,其中42%正在接受降压治疗,而仅有21%得到控制。2019年,全球范围内超过一半的心血管疾病死亡可归因于收缩压升高,如果全球范围内将高血压控制率提高到50%,从2023年至2050年间可以避免7 600万人死亡。人群水平的高血压相关危险因素包括高盐和低钾摄入、饮酒、缺乏运动、空气污染等。WHO支持通过减少膳食钠摄入,增加钾摄入、限制饮酒、戒烟、增加运动和改善空气污染等方式预防和控制高血压。治疗方面,WHO指南建议对收缩压≥140 mmHg或舒张压≥90 mmHg的个体使用降压药物治疗。对于特定人群,收缩压在130~139 mmHg之间时也建议开始使用降压药物治疗,同时推荐使用单片复方制剂进行联合治疗,以提高治疗的依从性和持久性。我国高血压的流行趋势和管理情况同样令人关注。高血压是我国人群中重要的死亡和疾病负担因素,通过学习和借鉴全球高血压管理的成功经验,可以加强我国高血压的预防、控制和监测工作,特别是推动HEARTS技术包在我国的应用,以提升高血压管理效果。该报告旨在提醒人们重点关注非传染性疾病,特别是高血压这一公共卫生挑战,通过详细的数据分析和成功案例明确了高血压防治的重要性,并为各国制定相关政策提供了科学依据,为实现2025年将未控制高血压比例较2010年相对下降25%的全球目标而共同努力。本文结合中国高血压病的流行趋势与管理情况对该报告进行简要解读。
中图分类号:
张冬燕, 李燕. 世界卫生组织《全球高血压报告》(2023年)概要及解读[J]. 诊断学理论与实践, 2024, 23(03): 297-304.
ZHANG Dongyan, LI Yan. Summary and interpretation of the World Health Organization “Global Report on Hypertension”[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(03): 297-304.
表1
按WHO区域划分的2019年30~79岁成人高血压年龄标化患病率以及诊断、治疗和有效治疗覆盖率[%(95%CI)]
区域 | 高血压患病率(%) | 诊断覆盖率(%) | 治疗覆盖率(%) | 有效治疗覆盖率(%) |
---|---|---|---|---|
非洲 | 36 (38~33) | 43 (46~39) | 27 (30~24) | 12 (14~9) |
美洲 | 35 (38~33) | 70 (73~67) | 60 (64~57) | 36 (41~32) |
东南亚 | 32 (36~29) | 39 (44~34) | 30 (34~25) | 14 (18~10) |
欧洲 | 37 (39~35) | 66 (69~63) | 53 (56~50) | 26 (29~23) |
地中海东部 | 38 (41~35) | 49 (53~45) | 39 (43~34) | 15 (19~13) |
西太平洋 | 28 (32~25) | 54 (59~48) | 41 (47~35) | 18 (23~14) |
全球 | 33 (35~32) | 54 (56~51) | 42 (45~40) | 21 (23~19) |
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