Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: Data from the National Health and Nutrition Examination Survey 1999-2004
Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: Data from the National Health and Nutrition Examination Survey 1999-2004
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DOI：
10.1038/ajh.2008.185
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发表时间：
2008-07-01
影响因子：
3.2
通讯作者：
Dillon, Charles F.
中科院分区：
文献类型：
--
作者：
Gu, Qiuping;Burt, Vicki L.;Dillon, Charles F.
背景国家指南建议对男性和女性采用相同的方法治疗高血压。然而，目前尚不清楚目前美国降压药的使用模式以及由此导致的血压(BP)控制程度在高血压女性和男性中是否相似或不同。方法这项研究是对非制度化的美国平民人口进行的一项具有全国代表性的横断面调查。根据1999-2004年国家健康和营养检查调查(NHANES)，年龄=18岁的人被归类为高血压，根据BP&>=140/90 mm Hg，正在服用降压药或已被医生诊断为高血压。结果高血压患者中，女性抗高血压药物的使用率显著高于男性(61.4%对56.8%)，特别是在中年人(40-49岁，53.1%对42.7%)和非西班牙裔黑人(65.5%对54.6%)中。此外，接受治疗的女性比男性更有可能使用利尿剂(31.6%比22.3%)和血管紧张素受体阻滞剂(11.3%比8.7%)。在接受治疗的高血压患者中，女性服用三种或三种以上抗高血压药物的比例低于男性，尤其是在老年人中(60-69岁：12.3%比19.8%，70-79岁：18.6%比21.2%，以及>；=80岁：18.8%比22.8%)。只有44.8%的接受治疗的女性实现了血压控制，而接受治疗的男性为51.1%。结论高血压女性接受治疗的可能性明显高于男性，但实现血压控制的可能性较小。可能需要额外的努力来实现美国高血压人群的治疗目标，特别是高血压女性的治疗目标。
BACKGROUNDNational guidelines recommend the same approach for treating hypertensive men and women. It is not known, however, whether current US antihypertensive medication utilization patterns and the resulting degrees of blood pressure (BP) control are similar or different among hypertensive women and men.METHODSThe study was a cross-sectional, nationally representative survey of the noninstitutionalized civilian US population. Persons aged >= 18 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were classified as hypertensive based on a BP >= 140/90 mm Hg, currently taking antihypertensive medication, or having been diagnosed by a physician.RESULTSAmong hypertensives, the prevalence of anti hypertensive medication use was significantly higher among women than men (61.4% vs. 56.8%), especially among middle-aged persons (40-49 years, 53.1 % vs. 42.7%) and among non-Hispanic blacks (65.5% vs. 54.6%). Also, treated women were more likely than men to use diuretics (31.6% vs. 22.3%) and angiotensin receptor blockers (11.3% vs. 8.7%). Among treated hypertensives, the proportion taking three or more anti hypertensive drugs was lower among women than men, especially among older persons (60-69 years: 12.3% vs. 19.8%, 70-79 years: 18.6% vs. 21.2%, and >= 80 years: 18.8% vs. 22.8%). Only 44.8% of treated women achieved BP control vs. 51.1 % of treated men.CONCLUSIONSHypertensive women are significantly more likely to be treated than men, but less likely to have achieved BP control. Additional efforts may be needed to achieve therapeutic goals for the US hypertensive population, especially for hypertensive women.