Changes in the Prevalence of Chronic Hypertension in Pregnancy, United States, 1970 to 2010
Changes in the Prevalence of Chronic Hypertension in Pregnancy, United States, 1970 to 2010
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DOI：
10.1161/hypertensionaha.119.12968
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发表时间：
2019-11-01
期刊：
影响因子：
8.3
通讯作者：
Joseph, K. S.
中科院分区：
文献类型：
--
作者：
Ananth, Cande, V;Duzyj, Christina M.;Joseph, K. S.
我们估计了孕妇慢性高血压患病率的变化，并评估了肥胖和吸烟的变化与这些趋势的相关程度。我们设计了一项基于人群的横断面分析，分析了1970年至2010年美国超过1.51亿名与分娩相关的住院妇女。母亲年龄、分娩年份（周期）、母亲出生年份（出生队列）以及种族被视为慢性高血压的危险因素。通过年龄-时期-队列模型得出与年龄、时期和出生队列相关的慢性高血压患病率和率比及其95%CI。我们还研究了肥胖和吸烟率的变化如何影响年龄-时期-队列效应。慢性高血压的总体患病率为0.63%，黑人女性（1.24%）的患病率是白色女性的2倍多（0.53%;率比，2.31; 95%CI，2.30-2.32）。在年龄-时期-队列分析中，慢性高血压的发生率随着年龄和时期的增加而急剧增加，从1970年的0.11%增加到2010年的1.52%（率比，13.41; 95%CI，13.22-13.61）。高血压发病率平均每年增加6%（95% CI，5-6），白色妇女的增幅（7%; 95% CI，6%-7%）略高于黑人妇女（4%; 95% CI，3%-4%）。调整肥胖率和吸烟率的变化与年龄和时期的影响无关。我们观察到慢性高血压发病率随年龄和时期而显著增加，慢性高血压发病率的种族差异超过2倍。
We estimated changes in the prevalence of chronic hypertension among pregnant women and evaluated the extent to which changes in obesity and smoking were associated with these trends. We designed a population-based cross-sectional analysis of over 151 million women with delivery-related hospitalizations in the United States, 1970 to 2010. Maternal age, year of delivery (period), and maternal year of birth (birth cohort), as well as race, were examined as risk factors for chronic hypertension. Prevalence rates and rate ratios with 95% CIs of chronic hypertension in relation to age, period, and birth cohort were derived through age-period-cohort models. We also examined how changes in obesity and smoking rates influenced age-period-cohort effects. The overall prevalence of chronic hypertension was 0.63%, with black women (1.24%) having more than a 2-fold higher rate than white women (0.53%; rate ratio, 2.31; 95% CI, 2.30-2.32). In the age-period-cohort analysis, the rate of chronic hypertension increased sharply with advancing age and period from 0.11% in 1970 to 1.52% in 2010 (rate ratio, 13.41; 95% CI, 13.22-13.61). The rate of hypertension increased, on average, by 6% (95% CI, 5-6) per year, with the increase being slightly higher among white (7%; 95% CI, 6%-7%) than black (4%; 95% CI, 3%-4%) women. Adjustments for changes in rates of obesity and smoking were not associated with age and period effects. We observed a substantial increase in chronic hypertension rates by age and period and an over 2-fold race disparity in chronic hypertension rates.