Continued increases in blood pressure over two decades in Samoa (1991-2013); around one-third of the increase explained by rising obesity levels
Continued increases in blood pressure over two decades in Samoa (1991-2013); around one-third of the increase explained by rising obesity levels
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DOI：
10.1186/s12889-018-6016-2
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发表时间：
2018-09-15
影响因子：
4.5
通讯作者：
Zimmet, Paul
中科院分区：
文献类型：
--
作者：
Linhart, Christine;Naseri, Take;Zimmet, Paul
工作背景：分析1991-2013年期间萨摩亚25-64岁成年人的收缩压、舒张压和高血压患病率的趋势;并评估肥胖水平上升对这一时期趋势的影响。1991年至2013年期间进行的7项基于人口的调查（n = 10，881）的单位记录数据被纳入分析。为提高国家代表性，对调查进行了调整，使之与最近的上一次人口普查相吻合。高血压定义为SBP ≥ 140 mmHg和/或DBP ≥ 90 mmHg和/或正在接受高血压药物治疗。肥胖通过体重指数（BMI）测量。结果：1991-2013年，男性和女性的平均收缩压（SBP）和舒张压（DBP）（mmHg）以及高血压患病率（%）均呈上升趋势。高血压的增加是：男性从18.3%到33.9%（p < 0.001）（平均血压从122/74到132/78）;女性从14.3%到26.4%（p < 0.001）（平均血压从118/73到126/78）。1991-2013年年龄调整后的平均SBP和DBP估计值以及2013年与1991年相比的高血压相对风险在调整BMI后有所减弱：平均SBP减少22%（男性）和32%（女性）;平均DBP减少37%（男性）和32%（女性）;高血压男女均减少19%。1991-2013年期间，萨摩亚男女的收缩压/舒张压和高血压患病率显著增加，这将大大增加心血管疾病造成的过早死亡率。肥胖症占萨摩亚人口血压上升趋势的三分之一左右。萨摩亚需要通过减少肥胖和盐的摄入量，加强对高血压的人口控制，并通过初级保健进行病例发现和治疗，以减少心血管疾病造成的过早死亡。
Background: To analyse trends over the period 1991-2013 in systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension in adults aged 25-64 years in Samoa; and to assess the contribution of rising obesity levels to period trends.Methods: Unit record data from seven population-based surveys (n = 10,881) conducted between 1991 and 2013 were included for analysis. Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP >= 140 mmHg and/or DBP >= 90 mmHg and/or on medication for hypertension. Obesity was measured by body mass index (BMI). Poisson, linear and meta-regression were used to assess period trends.Results: Over 1991-2013 mean SBP and DBP (mmHg), and the prevalence of hypertension (%) increased in both sexes. Increases in hypertension were: from 18.3 to 33.9% (p < 0.001) in men (mean BP from 122/74 to 132/78); and from 14.3 to 26.4% (p < 0.001) in women (mean BP from 118/73 to 126/78). The estimate of the age-adjusted mean SBP and DBP over 1991-2013, and the relative risk for hypertension in 2013 compared to 1991, were attenuated after adjusting for BMI: by 22% (men) and 32% (women) for mean SBP; 37% (men) and 32% (women) for mean DBP; and 19% in both sexes for hypertension.Conclusions: Significant increases have occurred in SBP/DBP and hypertension prevalence in both sexes in Samoa during 1991-2013, which would contribute significantly to premature mortality from cardiovascular disease. Obesity accounts for around one-third of the rising trend in blood pressure in the Samoan population. Strengthening of population control of hypertension through reduction in obesity and salt intake, and case detection and treatment through primary care, is required to reduce premature mortality from cardiovascular disease in Samoa.