内科理论与实践

内科理论与实践 ›› 2022, Vol. 17 ›› Issue (04): 273-277.doi: 10.16138/j.1673-6087.2022.04.001

• 论著 •    下一篇

不同诊断标准对人群高血压患病率的影响

李歆旎1a, 马文坤1a, 高程洁1b, 高亚洁1a, 金雪娟2, 周翌1a, 沈成兴1a, 潘静薇1a()   

  1. 1.上海交通大学附属第六人民医院a. 心血管内科;b. 老年科,上海 200233
    2.复旦大学附属中山医院心内科 上海市心血管病研究所,上海 200032
  • 收稿日期:2022-01-21 出版日期:2022-07-18 发布日期:2022-08-08
  • 通讯作者: 潘静薇 E-mail:jwpan@sjtu.edu.cn
  • 基金资助:
    国家重点研发计划课题(2018YFC 2000800);上海市2021年度“科技创新行动计划”医学创新研究专项项目(21Y11909400)

Influence of different diagnostic criteria on the prevalence of hypertension in the population

LI Xinni1a, MA Wenkun1a, GAO Chengjie1b, GAO Yajie1a, JIN Xuejuan2, ZHOU Yi1a, SHEN Chengxing1a, PAN Jingwei1a()   

  1. 1a. Department of Cardiology; b. Department of Geriatrics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
    2. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China
  • Received:2022-01-21 Online:2022-07-18 Published:2022-08-08
  • Contact: PAN Jingwei E-mail:jwpan@sjtu.edu.cn

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摘要：

目的： 比较2017年美国高血压诊断标准（美国标准）与中国高血压防治指南（2018年修订版）诊断标准（我国标准）在普通人群中诊断高血压患病率的差异。方法： 采用整群分层随机抽样的方法,从上海交通大学附属第六人民医院2015—2019年体检人群数据库中,按年龄每10岁1个分层,每层每年随机抽取20名,男女各半。调查内容包括病史,身高、体重、血压测量,血液生化指标检测等,体检项目与内容均采用统一标准化方法。按照我国高血压定义标准[≥140/90 mmHg（1 mmHg = 0.133 kPa）或正在服用降血压药物]和美国高血压定义标准（≥130/80 mmHg或正在服用降血压药物）分别计算不同性别、年龄人群高血压患病率。结果： 我国标准下人群高血压患病率为27.3%（男性为29.0%、女性为25.7%）,美国标准下人群高血压患病率为55.8%（男性为65.3%、女性为46.3%）。收缩压随年龄增长呈线性增加,而舒张压随年龄增长呈现倒“U”分布。按年龄不同分为20~29、30~39、40~49、50~59、60~69和70~79岁共6个年龄组,2种定义下的高血压患病率均随年龄增长而增高,其中50~59岁和60~69岁组2种诊断差异最大,分别增长37.0%和39.0%。各年龄组中除中国标准的60~69岁和70~79岁组以及美国标准的70~79岁组,其余各年龄组高血压患病率男性大于女性（均P<0.05）。2种诊断标准导致男性高血压的诊断率差异较大。结论： 参照新版美国高血压定义,我国中青年组高血压患病率显著升高,应尽早关注该组人群血压问题,以防代治,及早进行生活和医疗干预,降低心脑血管病风险。

关键词: 血压, 高血压, 患病率

Abstract:

Objective To compare the difference in the prevalence of hypertension diagnosed with the 2017 American hypertension diagnostic criteria (American standard) and the Chinese guidelines for the prevention and treatment of hypertension (2018 revised edition, Chinese standard) in the general population. Methods The cluster stratified random sampling method was adopted. The population samples were collected from the population database of physical examination between 2015 and 2019 in Shanghai Sixth People’s Hospital and were stratified by every 10 years. Twenty people including 10 males and 10 females were randomly selected from every year, which was defined as one layer. The information of investigation included medical history investigation, height, weight, blood pressure measurement, blood biochemical index detection, etc. Both the items and information of the physical examination adopted unified and standardized testing methods. According to the definition of hypertension in China standard [≥140/90 mmHg (1 mmHg=0.133 kPa) or taking antihypertensive drugs right now]and in American standard(≥130/80 mmHg or taking antihypertensive drugs right now), the prevalence of hypertension in people in different genders and ages were calculated, respectively. Results The population prevalence of hypertension based on Chinese standard was 27.3%(29.0% in male and 25.7% in female); the population prevalence of hypertension based on American standard was 55.8% (65.3% in men and 46.3% in women); the systolic blood pressure showed a linear increase with age, while the diastolic blood pressure showed an inverted“U” distribution with age; the prevalence of hypertension based on both definitions increased with age in 6 age groups, which were 20-29, 30-39, 40-49, 50-59, 60-69 and 70-79 years. Furthermore, the age groups of 50-59 and 60-69 showed the largest differences in two diagnostic criteria, with an increase of 37.0% and 39.0%, respectively. The prevalence of hypertension in male was higher than female in most age groups except the groups of 60-69 and 70-79 years in Chinese standard and the group of 70-79 years in American standard (all P<0.05). The two diagnostic criteria led to large difference in the diagnostic rate of hypertension in male. Conclusions According to 2017 American standard, the prevalence of Chinese young and middle-aged people diagnosed as hypertension increased significantly compared to Chinese standard of 2018. Therefore, more attention should be given to this group, and the lifestyle and medical interventions should be carried out early to reduce the risk of cardiovascular and cerebrovascular diseases.

Key words: Blood pressure, Hypertension, Prevalence

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