Prevalence of high blood pressure and elevated serum creatinine level in the United States -: Findings from the Third National Health and Nutrition Examination Survey (1988-1994)
Prevalence of high blood pressure and elevated serum creatinine level in the United States -: Findings from the Third National Health and Nutrition Examination Survey (1988-1994)
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DOI：
10.1001/archinte.161.9.1207
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发表时间：
2001-05-14
影响因子：
--
通讯作者：
Klag, MJ
中科院分区：
文献类型：
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作者：
Coresh, J;Wei, L;Klag, MJ
背景：在美国，终末期肾脏疾病的患病率和发病率正在上升，但较轻的肾脏疾病更为常见，往往未被诊断和治疗不足。方法：在1988年至1994年进行的第三次全国健康与营养检查调查（NHANES III）中，对16589名17岁及以上的美国人口代表性样本进行了横断面研究。男性血清肌酐水平升高定义为141 μ mol/L或更高（大于或等于1.6 mg/dL），女性血清肌酐水平升高定义为124 μ mol/L或更高（大于或等于1.4 mg/dL）（健康年轻成人的第99百分位数），这是主要的结局指标。结果：较高的收缩压和舒张压、高血压的存在、降压药的使用、年龄和糖尿病都与较高的血清肌酐水平有关。据估计，3.0%（560万）非住院美国平民血清肌酐水平升高，其中70%为高血压。在血清肌酐水平升高的高血压患者中，75%接受了治疗。然而，只有11%的高血压患者血压降至130/85毫米汞柱以下（高血压检测、评估和治疗联合全国委员会第六次报告建议高血压患者合并肾脏疾病）；27%的高血压患者血压低于140/90毫米汞柱。肌酐水平升高的高血压患者的平均血压为147/77毫米汞柱，其中48%的人服用了一种抗高血压药物。结论：血清肌酐水平升高是慢性肾脏疾病的一项指标，与高血压治疗不当密切相关。
Background: The prevalence and incidence of endstage renal disease in the United States are increasing, but milder renal disease is much more common and may often go undiagnosed and undertreated.Methods: A cross-sectional study of a representative sample of the US population was conducted using 16589 adult participants aged 17 years and older in the Third National Health and Nutrition Examination Survey (NHANES III) conducted from 1988 to 1994. An elevated serum creatinine level was defined as 141 mu mol/L or higher (greater than or equal to1.6 mg/dL) for men and 124 mu mol/L or higher (greater than or equal to1.4 mg/dL) for women (>99th percentile for healthy young adults) and was the main outcome measure.Results: Higher systolic and diastolic blood pressures, presence of hypertension, antihypertensive medication use, older age, and diabetes mellitus were all associated with higher serum creatinine levels. An estimated 3.0% (5.6 million) of the civilian, noninstitutionalized US population had elevated serum creatinine levels, 70% of whom were hypertensive. Among hypertensive individuals with an elevated serum creatinine level, 75% received treatment. However, only 11% of all individuals with hypertension had their blood pressure reduced to lower than 130/85 mm Hg (the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure recommendation for hypertensive individuals with renal disease); 27% had a blood pressure lower than 140/90 mm Hg. Treated hypertensive individuals with an elevated creatinine level had a mean blood pressure of 147/77 mm Hg, 48% of whom were prescribed one antihypertensive medication.Conclusion: Elevated serum creatinine level, an indicator of chronic renal disease, is common and strongly related to inadequate treatment of high blood pressure.