Age-dependent gender differences in hypertension management.
Age-dependent gender differences in hypertension management.
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DOI：
10.1097/hjh.0b013e3283449512
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发表时间：
2011-05
影响因子：
4.9
通讯作者：
Magid DJ
中科院分区：
文献类型：
--
作者：
Daugherty SL;Masoudi FA;Ellis JL;Ho PM;Schmittdiel JA;Tavel HM;Selby JV;O'Connor PJ;Margolis KL;Magid DJ
尽管性别中立的指导方针，先前的研究表明，女性的高血压控制率较低，这些差异可能会随着年龄的不同而不同。因此，我们比较了女性和男性之间的高血压控制率与年龄的关系。在心血管研究网络的3个集成医疗系统中，我们研究了2001-2007年间发现的所有高血压患者。在进入队列的1年内，患者的高血压被分类为：1)根据达到指南推荐的血压水平进行控制，2)确认是否诊断为高血压或分发高血压药物，以及3)根据分发的高血压药物进行治疗。经患者特征调整后，多变量Logistic回归模型评估了性别和1年高血压结局之间的关联。在152,561名高血压患者中，55.6%是女性。与男性相比，女性年龄更大，有更多的肾脏疾病，在随访期间有更多的血压测量。总体而言，男性的高血压控制率往往低于女性(41.2%对45.7%，调整后OR为0.93，96%CI为0.91-0.95)。与年龄相似的女性相比，年龄在18-49岁的男性高血压控制几率低17%，而≥65岁的男性高血压控制几率高12%(p<；0.001)。在这一高血压事件队列中，与年龄相近的同龄人相比，年轻男性和老年女性的高血压控制率较低。未来的研究应该调查为什么性别差异因年龄而不同，以便计划适当的方法来改善高血压的管理，而不考虑性别或年龄。
Despite gender neutral guidelines, prior studies suggest that women have lower rates of hypertension control and these differences may vary with age. Accordingly, we compared rates of hypertension control between women and men as a function of age. Within 3 integrated healthcare systems in the Cardiovascular Research Network, we studied all patients seen from 2001–2007 with incident hypertension. Within 1-year of cohort entry, patient’s hypertension was categorized as: 1) controlled based upon achieving guideline-recommended BP levels, 2) recognized if hypertension was diagnosed or a hypertension medication dispensed, and 3) treated based on hypertension medications dispensed. Multivariable logistic regression models assessed the association between gender and 1-year hypertension outcomes, adjusted for patient characteristics. Among the 152,561 patients with incident hypertension, 55.6% were women. Compared to men, women were older, had more kidney disease and more blood pressure measures during follow-up. Overall, men tended to have lower rates of hypertension control compared to women (41.2% vs. 45.7%, adjusted OR 0.93, 96% CI 0.91–0.95). A significant gender by age interaction was found with men aged 18–49 having 17% lower odds of hypertension control and men aged ≥ 65 having 12% higher odds of hypertension control compared to women of similar ages (p<0.001). In this incident hypertension cohort, younger men and older women had lower rates of hypertension control compared to similarly aged peers. Future studies should investigate why gender differences vary by age in order to plan appropriate means of improving hypertension management regardless of gender or age.