Factors associated with the prevalence of hypertension in the southeastern United States: insights from 69,211 blacks and whites in the Southern Community Cohort Study.
Factors associated with the prevalence of hypertension in the southeastern United States: insights from 69,211 blacks and whites in the Southern Community Cohort Study.
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DOI：
10.1161/circoutcomes.113.000155
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发表时间：
2014-01
期刊：
影响因子：
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通讯作者：
Lipworth L
中科院分区：
文献类型：
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作者：
Sampson UK;Edwards TL;Jahangir E;Munro H;Wariboko M;Wassef MG;Fazio S;Mensah GA;Kabagambe EK;Blot WJ;Lipworth L
生活方式和社会经济地位与高血压患病率有关；因此，我们在具有相似社会经济地位特征的黑人和白人队列中评估了与高血压相关的因素。我们评估了南方社区队列研究中69211名参与者的高血压患病率和与自我报告高血压（SR-HTN）和确诊高血压（A-HTN）相关的因素。采用多变量logistic回归模型估计高血压相关因素的比值比（ORs）和95%置信区间（CIs）。SR-HTN的总体患病率为57%。在所有种族-性别组中，体重指数与SR-HTN相关，对于病态肥胖参与者（体重指数，40 kg/m2）， OR上升到4.03 （95% CI, 3.74-4.33）。黑人比白人更容易患SR-HTN (OR, 1.84; 95% CI, 1.75-1.93)，女性（OR, 2.08; 95% CI, 1.95-2.21）比男性（OR, 1.47; 95% CI, 1.36-1.60）与黑人种族的关系更为明显。在对A-HTN的分析中也发现了类似的结果。在报告使用降压药的SR-HTN和a - htn患者中，94%的患者至少使用一种主要的降压药，但只有44%的患者使用≥2种降压药，只有29%的患者使用利尿剂。未控制的高血压（SR-HTN和A-HTN）和未报告的高血压（无SR-HTN和A-HTN）在黑人中的几率是白人的两倍（OR, 2.13; 95% CI, 1.68-2.69； OR, 1.99; 95% CI, 1.59-2.48）。尽管社会经济地位相似，但我们观察到该队列中抗高血压药物的次优使用以及未控制和未报告的高血压患病率的种族差异，值得进一步调查。
Lifestyle and socioeconomic status have been implicated in the prevalence of hypertension; thus, we evaluated factors associated with hypertension in a cohort of blacks and whites with similar socioeconomic status characteristics. We evaluated the prevalence and factors associated with self-reported hypertension (SR-HTN) and ascertained hypertension (A-HTN) among 69 211 participants in the Southern Community Cohort Study. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with hypertension. The prevalence of SR-HTN was 57% overall. Body mass index was associated with SR-HTN in all race-sex groups, with the OR rising to 4.03 (95% CI, 3.74–4.33) for morbidly obese participants (body mass index, >40 kg/m2). Blacks were more likely to have SR-HTN than whites (OR, 1.84; 95% CI, 1.75–1.93), and the association with black race was more pronounced among women (OR, 2.08; 95% CI, 1.95–2.21) than men (OR, 1.47; 95% CI, 1.36–1.60). Similar findings were noted in the analysis of A-HTN. Among those with SR-HTN and A-HTN who reported use of an antihypertensive agent, 94% were on at least one of the major classes of antihypertensive agents, but only 44% were on ≥2 classes and only 29% were on a diuretic. The odds of both uncontrolled hypertension (SR-HTN and A-HTN) and unreported hypertension (no SR-HTN and A-HTN) were twice as high among blacks as whites (OR, 2.13; 95% CI, 1.68–2.69; and OR, 1.99; 95% CI, 1.59–2.48, respectively). Despite socioeconomic status similarities, we observed suboptimal use of antihypertensives in this cohort and racial differences in the prevalence of uncontrolled and unreported hypertension, which merit further investigation.