Closing the gap in hypertension control between younger and older adults: National Health and Nutrition Examination Survey (NHANES) 1988 to 2010.
Closing the gap in hypertension control between younger and older adults: National Health and Nutrition Examination Survey (NHANES) 1988 to 2010.
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DOI：
10.1161/circulationaha.113.007699
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发表时间：
2014-05-20
期刊：
影响因子：
37.8
通讯作者：
Sinopoli A
中科院分区：
文献类型：
--
作者：
Egan BM;Li J;Shatat IF;Fuller JM;Sinopoli A
从1984年到2013年，联合全国委员会的目标是所有成年人的血压(BP)为&140/<；90毫米汞柱或更低。60岁以上的成年人≥主要是单纯的收缩期高血压(ISH)，主要试验的血压达到收缩压150，但不是140。主要目的是评估高血压控制在年轻人(60岁)和老年人(90岁)和90岁(90岁)中的变化。分析了1988~1994年、1999年~2004年、2005年~2010年≥18岁成人的国民健康与营养状况调查结果。从1988年至1994年到2005年至2010年，老年(31.6%至53.1%，p<；0.001)和年轻(45.7%至55.9%，p<；0.001)患者的高血压控制改善至90%。对照组的年龄差距从1988-1994年的14.1%(p<；0.01)下降到2005-2010年的2.8%(p=0.13)。更好的高血压控制反映了接受治疗的老年患者(55.6%至77.5%)和年轻患者(34.6%至54.7%)的百分比增加，接受治疗的老年患者(45.7%至64.9%)和年轻患者(56.8%至73.4%)的比例得到控制(均P<；0.001)。在老年人中，150/90的控制率从48.8%上升到69.9%。在两个年龄组中，服用≥3药物的降压药数量和百分比都有所增加，但在老年患者中增加得更多(p<；0.01)。血压控制率在≥为2次/年和他汀类药物治疗的两个年龄组中都较高。随着临床医生加强治疗，高血压控制到90岁的年龄差距在2005-2010年间几乎消除了，特别是在老年患者中，ISH占主导地位，控制了70%到150/90岁。更频繁的保健和他汀类药物治疗可能会改善所有成年人的高血压控制。
Joint National Committee goal blood pressure (BP) for all adults was <140/<90 mmHg or lower from 1984 to 2013. Adults ≥60 years (older) have mainly isolated systolic hypertension (ISH) with major trials attaining systolic BP <150 but not <140. The main objective was to assess changes in hypertension control to <140/<90 in younger (<60 years) and older adults and <150/<90 in the latter. National Health and Nutrition Examination Surveys (NHANES) 1988–1994, 1999–2004, 2005–2010 were analyzed in adults ≥18 years. From 1988–1994 to 2005–2010, hypertension control to <140/<90 improved in older (31.6% to 53.1%, p<0.001) and younger (45.7% to 55.9%, p<0.001) patients. The age gap in control declined from 14.1% (p<0.01) in 1988–1994 to 2.8% (p=0.13) in 2005–2010. Better hypertension control reflected increased percentages of older (55.6% to 77.5%) and younger (34.6% to 54.7%) patients on treatment and treated older (45.7% to 64.9%) and younger patients (56.8% to 73.4%) controlled (all p<0.001). Control to <150/<90 rose from 48.8% to 69.9% in older adults. Antihypertensive medication number and percentages on ≥3 medications increased in both age groups but more in older patients (p<0.01). BP control was higher in both age groups with ≥2 healthcare visits/year and statin therapy. The age gap in hypertension control to <140/<90 was virtually eliminated in 2005–2010 as clinicians intensified therapy, especially in older patients where ISH predominates controlling 70% to <150/<90. More frequent healthcare and statin therapy may improve hypertension control in all adults.