Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000
Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000
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DOI：
10.1001/jama.290.2.199
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发表时间：
2003-07-09
影响因子：
120.7
通讯作者：
Kotchen, TA
中科院分区：
文献类型：
--
作者：
Hajjar, I;Kotchen, TA
背景：1991年之前对国家健康和营养调查（NHANES）数据的分析表明，高血压的患病率正在下降，但最近自我报告的高血压发病率表明，高血压的发病率正在上升。和参与者调查使用分层多级概率样本的平民非制度化的人口。最近的NHANES调查，在1999-2000年进行（n=5448），进行了比较，在1988-1991年（n=9901）和1991-1994年（n =9717）进行的NHANES III的两个阶段。本分析包括18岁或以上的个人。主要结果测量高血压，定义为测量的血压为140/90 mm Hg或更高或报告使用抗高血压药物。高血压的认识和治疗进行了评估标准化的问题。高血压控制被定义为治疗与抗高血压药物和测量的血压小于140/90毫米Hg.Results在1999-2000年，28.7%的NHANES参与者有高血压，增加了3.7%（95%置信区间[CI]，0%-8.3%），从1988-1991年。高血压患病率在非西班牙裔黑人中最高（33.5%），随年龄增长而增加（60岁以上人群中为65.4%），女性患病率更高（30.1%）。在多元回归分析中，年龄增加、体重指数增加和非西班牙裔黑人种族与高血压发病率增加独立相关。总体而言，在1999-2000年，68.9%的人知道自己患有高血压（非显著性下降-0.3%; 95% CI，-4.2%至3.6%），58.4%接受治疗（增加6.0%; 95%CI，1.2%-10.8%），高血压控制率为31.0%（增加6.4%; 95%CI，1.6%-11.2%）。妇女，墨西哥裔美国人，和那些年龄在60岁或以上的控制率显着较低的男性，年轻人，和非西班牙裔white.Conclusions相反，早期的报告，高血压患病率在美国增加。高血压控制率虽然有所改善，但仍然很低。针对高血压预防和治疗的计划至关重要。
Context Prior analyses of National Health and Nutrition Examination Survey (NHANES) data through 1991 have suggested that hypertension prevalence is declining, but more recent self-reported rates of hypertension suggest that the rate is increasing.Objective To describe trends in the prevalence, awareness, treatment, and control of hypertension in the United States using NHANES data.Design, Setting, and Participants Survey using a stratified multistage probability sample of the civilian noninstitutionalized population. The most recent NHANES survey, conducted in 1999-2000 (n=5448), was compared with the 2 phases of NHANES III conducted in 1988-1991 (n=9901) and 1991-1994 (n =9717). Individuals aged 18 years or older were included in this analysis.Main Outcome Measures Hypertension, defined as a measured blood pressure of 140/90 mm Hg or greater or reported use of anti hypertensive medications. Hypertension awareness and treatment were assessed with standardized questions. Hypertension control was defined as treatment with anti hypertensive medication and a measured blood pressure of less than 140/90 mm Hg.Results In 1999-2000, 28.7% of NHANES participants had hypertension, an increase of 3.7% (95% confidence interval [CI], 0%-8.3%) from 1988-1991. Hypertension prevalence was highest in non-Hispanic blacks (33.5%), increased with age (65.4% among those aged greater than or equal to60 years), and tended to be higher in women (30.1%). In a multiple regression analysis, increasing age, increasing body mass index, and non-Hispanic black race/ethnicity were independently associated with increased rates of hypertension. Overall, in 1999-2000, 68.9% were aware of their hypertension (nonsignificant decline of -0.3%; 95% CI, -4.2% to 3.6%), 58.4% were treated (increase of 6.0%; 95% Cl, 1.2%-10.8%), and hypertension was controlled in 31.0% (increase of 6.4%; 95% Cl, 1.6%-11.2%). Women, Mexican Americans, and those aged 60 years or older had significantly lower rates of control compared with men, younger individuals, and non-Hispanic whites.Conclusions Contrary to earlier reports, hypertension prevalence is increasing in the United States. Hypertension control rates, although improving, continue to be low. Programs targeting hypertension prevention and treatment are of utmost importance.